Provider Demographics
NPI:1932712650
Name:PERRY, JAMIE (LPC)
Entity Type:Individual
Prefix:
First Name:JAMIE
Middle Name:
Last Name:PERRY
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2900 PACES FERRY RD SE STE 202
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30339-5702
Mailing Address - Country:US
Mailing Address - Phone:770-695-7203
Mailing Address - Fax:
Practice Address - Street 1:2900 PACES FERRY RD SE STE 202
Practice Address - Street 2:
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30339-5702
Practice Address - Country:US
Practice Address - Phone:770-695-7203
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-08-24
Last Update Date:2024-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GALPC014196101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional