Provider Demographics
NPI:1801687686
Name:CATCHPOLE, JESSICA ANNE (APC)
Entity type:Individual
Prefix:
First Name:JESSICA
Middle Name:ANNE
Last Name:CATCHPOLE
Suffix:
Gender:F
Credentials:APC
Other - Prefix:
Other - First Name:JESSIE
Other - Middle Name:
Other - Last Name:CATCHPOLE
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:APC
Mailing Address - Street 1:1210 RIDGEFIELD DR
Mailing Address - Street 2:
Mailing Address - City:ROSWELL
Mailing Address - State:GA
Mailing Address - Zip Code:30075-4117
Mailing Address - Country:US
Mailing Address - Phone:770-355-9050
Mailing Address - Fax:
Practice Address - Street 1:2801 BUFORD HWY NE STE 550B
Practice Address - Street 2:
Practice Address - City:BROOKHAVEN
Practice Address - State:GA
Practice Address - Zip Code:30329-2124
Practice Address - Country:US
Practice Address - Phone:770-355-9050
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-05-13
Last Update Date:2025-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAAPC010403101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional