Provider Demographics
NPI:1639286198
Name:JONI E PRINCE PHD PC
Entity Type:Organization
Organization Name:JONI E PRINCE PHD PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINICAL PSYCHOLOGIST
Authorized Official - Prefix:DR
Authorized Official - First Name:JONI
Authorized Official - Middle Name:E
Authorized Official - Last Name:PRINCE
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:404-461-9067
Mailing Address - Street 1:1185 HIGHTOWER TRL UNIT 500356
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:31150-3106
Mailing Address - Country:US
Mailing Address - Phone:404-735-4935
Mailing Address - Fax:404-735-4935
Practice Address - Street 1:6065 ROSWELL RD STE 515
Practice Address - Street 2:
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30328-4015
Practice Address - Country:US
Practice Address - Phone:404-461-9067
Practice Address - Fax:404-461-9067
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-23
Last Update Date:2021-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA1723103TC0700X
261QM0850X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Multi-Specialty
No261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental HealthGroup - Multi-Specialty