Provider Demographics
NPI:1760959050
Name:POPE, JOAN (LMSW)
Entity Type:Individual
Prefix:
First Name:JOAN
Middle Name:
Last Name:POPE
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6670 JAMES B RIVERS MEMORIAL DRIVE
Mailing Address - Street 2:SUITE 700
Mailing Address - City:STONE MOUNTAIN
Mailing Address - State:GA
Mailing Address - Zip Code:30038
Mailing Address - Country:US
Mailing Address - Phone:678-592-0636
Mailing Address - Fax:
Practice Address - Street 1:6670 JAMES B RIVERS MEMORIAL DRIVE
Practice Address - Street 2:SUITE 700
Practice Address - City:LITHONIA
Practice Address - State:GA
Practice Address - Zip Code:30038-3003
Practice Address - Country:US
Practice Address - Phone:678-592-0636
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-10-25
Last Update Date:2018-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAMSW006973101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health