Provider Demographics
NPI:1801365705
Name:GIORDANELLA, JAMES THOMAS (LPC)
Entity Type:Individual
Prefix:MR
First Name:JAMES
Middle Name:THOMAS
Last Name:GIORDANELLA
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 1:216 MUIRFIELD LN
Mailing Address - Street 2:
Mailing Address - City:BYRON
Mailing Address - State:GA
Mailing Address - Zip Code:31008-3903
Mailing Address - Country:US
Mailing Address - Phone:478-397-1432
Mailing Address - Fax:
Practice Address - Street 1:216 MUIRFIELD LN
Practice Address - Street 2:
Practice Address - City:BYRON
Practice Address - State:GA
Practice Address - Zip Code:31008-3903
Practice Address - Country:US
Practice Address - Phone:478-397-1432
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-11-20
Last Update Date:2021-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAAPC006213101YP2500X
GALPC011183101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
GAAPC006213OtherLAPC