Provider Demographics
NPI:1891170080
Name:JONES, MARCUS LANCE (LPC, CADCII)
Entity Type:Individual
Prefix:MR
First Name:MARCUS
Middle Name:LANCE
Last Name:JONES
Suffix:
Gender:M
Credentials:LPC, CADCII
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4606 WESTMINSTER DR
Mailing Address - Street 2:
Mailing Address - City:ELLENWOOD
Mailing Address - State:GA
Mailing Address - Zip Code:30294-3787
Mailing Address - Country:US
Mailing Address - Phone:470-437-9980
Mailing Address - Fax:
Practice Address - Street 1:4606 WESTMINSTER DR
Practice Address - Street 2:
Practice Address - City:ELLENWOOD
Practice Address - State:GA
Practice Address - Zip Code:30294-3787
Practice Address - Country:US
Practice Address - Phone:470-437-9980
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-07-29
Last Update Date:2022-11-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA0861101YA0400X
GA010807101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)