Provider Demographics
NPI:1841679271
Name:KRESS, JAMES (LPC, CADC2)
Entity type:Individual
Prefix:
First Name:JAMES
Middle Name:
Last Name:KRESS
Suffix:
Gender:M
Credentials:LPC, CADC2
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1681
Mailing Address - Street 2:
Mailing Address - City:STATESBORO
Mailing Address - State:GA
Mailing Address - Zip Code:30459-1681
Mailing Address - Country:US
Mailing Address - Phone:912-764-7785
Mailing Address - Fax:912-764-6977
Practice Address - Street 1:711 ZITTEROUR DR
Practice Address - Street 2:
Practice Address - City:RINCON
Practice Address - State:GA
Practice Address - Zip Code:31326-9269
Practice Address - Country:US
Practice Address - Phone:912-764-7785
Practice Address - Fax:912-764-6977
Is Sole Proprietor?:No
Enumeration Date:2015-05-18
Last Update Date:2015-05-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA491101YA0400X
GALPC003538101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional