Provider Demographics
NPI:1184250235
Name:MACFARLANE, JONATHAN A (MA, LPC, NCC)
Entity type:Individual
Prefix:
First Name:JONATHAN
Middle Name:A
Last Name:MACFARLANE
Suffix:
Gender:M
Credentials:MA, LPC, NCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:195 W PIKE ST STE 108
Mailing Address - Street 2:
Mailing Address - City:LAWRENCEVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30046-4966
Mailing Address - Country:US
Mailing Address - Phone:678-260-9471
Mailing Address - Fax:
Practice Address - Street 1:195 W PIKE ST STE 108
Practice Address - Street 2:
Practice Address - City:LAWRENCEVILLE
Practice Address - State:GA
Practice Address - Zip Code:30046-4966
Practice Address - Country:US
Practice Address - Phone:678-260-9471
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-03-20
Last Update Date:2024-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GALPC013566101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health