Provider Demographics
NPI:1689128027
Name:KINARD, JOR-REL (LPC)
Entity Type:Individual
Prefix:
First Name:JOR-REL
Middle Name:
Last Name:KINARD
Suffix:
Gender:M
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:211 PLEASANT HOME RD
Mailing Address - Street 2:SUITE G1
Mailing Address - City:AUGUSTA
Mailing Address - State:GA
Mailing Address - Zip Code:30907-0518
Mailing Address - Country:US
Mailing Address - Phone:706-364-4599
Mailing Address - Fax:706-364-4589
Practice Address - Street 1:211 PLEASANT HOME RD
Practice Address - Street 2:SUITE G1
Practice Address - City:AUGUSTA
Practice Address - State:GA
Practice Address - Zip Code:30907-0518
Practice Address - Country:US
Practice Address - Phone:706-364-4599
Practice Address - Fax:706-364-4589
Is Sole Proprietor?:Yes
Enumeration Date:2016-08-14
Last Update Date:2016-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GALPC009092101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional