Provider Demographics
NPI:1932845716
Name:HINSON, JEREMIAH (APC)
Entity Type:Individual
Prefix:
First Name:JEREMIAH
Middle Name:
Last Name:HINSON
Suffix:
Gender:M
Credentials:APC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2281 AKERS MILL RD SE APT 5816
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30339-2701
Mailing Address - Country:US
Mailing Address - Phone:404-825-2155
Mailing Address - Fax:
Practice Address - Street 1:1900 THE EXCHANGE SE STE 180
Practice Address - Street 2:
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30339-2049
Practice Address - Country:US
Practice Address - Phone:404-835-6121
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-05-05
Last Update Date:2022-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA0007178101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health