Provider Demographics
NPI:1710473467
Name:TOLES-JONES, THERESA A (MS, LPC, CPCS)
Entity Type:Individual
Prefix:
First Name:THERESA
Middle Name:A
Last Name:TOLES-JONES
Suffix:
Gender:F
Credentials:MS, LPC, CPCS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6794 SILVER MAPLE DR
Mailing Address - Street 2:
Mailing Address - City:REX
Mailing Address - State:GA
Mailing Address - Zip Code:30273-2351
Mailing Address - Country:US
Mailing Address - Phone:404-808-3736
Mailing Address - Fax:
Practice Address - Street 1:6794 SILVER MAPLE DR
Practice Address - Street 2:
Practice Address - City:REX
Practice Address - State:GA
Practice Address - Zip Code:30273-2351
Practice Address - Country:US
Practice Address - Phone:404-808-3736
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-07-05
Last Update Date:2018-07-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA3354101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional