Provider Demographics
NPI:1952678351
Name:JACORE COUNSELING
Entity Type:Organization
Organization Name:JACORE COUNSELING
Other - Org Name:JACORE ENTERPRISES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MRS
Authorized Official - First Name:MONICA
Authorized Official - Middle Name:PERKINS
Authorized Official - Last Name:KENT
Authorized Official - Suffix:
Authorized Official - Credentials:MA, LPC, NCC
Authorized Official - Phone:404-558-1676
Mailing Address - Street 1:119 BRUNSWICK DR
Mailing Address - Street 2:
Mailing Address - City:TYRONE
Mailing Address - State:GA
Mailing Address - Zip Code:30290-1560
Mailing Address - Country:US
Mailing Address - Phone:404-558-1676
Mailing Address - Fax:
Practice Address - Street 1:119 BRUNSWICK DR
Practice Address - Street 2:
Practice Address - City:TYRONE
Practice Address - State:GA
Practice Address - Zip Code:30290-1560
Practice Address - Country:US
Practice Address - Phone:404-558-1676
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-11-30
Last Update Date:2011-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX16881251S00000X
GA006217251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health