Provider Demographics
NPI:1013633353
Name:SHIOVITZ, JAHNA NIKITA (MS, LPC, NCC)
Entity Type:Individual
Prefix:
First Name:JAHNA
Middle Name:NIKITA
Last Name:SHIOVITZ
Suffix:
Gender:F
Credentials:MS, LPC, NCC
Other - Prefix:
Other - First Name:JAHNA
Other - Middle Name:NIKITA
Other - Last Name:CAROLINA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MS, LPC, NCC
Mailing Address - Street 1:3453 SPRING CIR
Mailing Address - Street 2:
Mailing Address - City:DECATUR
Mailing Address - State:GA
Mailing Address - Zip Code:30032-7222
Mailing Address - Country:US
Mailing Address - Phone:770-364-9913
Mailing Address - Fax:
Practice Address - Street 1:1821 CLIFTON RD NE STE 1200
Practice Address - Street 2:
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30329-4021
Practice Address - Country:US
Practice Address - Phone:404-712-5713
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-10-18
Last Update Date:2022-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GALPC013184101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional