Provider Demographics
NPI:1174099535
Name:JONES, HOLLY ELIZABETH (LPC)
Entity type:Individual
Prefix:MRS
First Name:HOLLY
Middle Name:ELIZABETH
Last Name:JONES
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:MISS
Other - First Name:HOLLY
Other - Middle Name:ELIZABETH
Other - Last Name:BROWN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LPC
Mailing Address - Street 1:3120 N OAK STREET EXT STE C
Mailing Address - Street 2:
Mailing Address - City:VALDOSTA
Mailing Address - State:GA
Mailing Address - Zip Code:31602-5910
Mailing Address - Country:US
Mailing Address - Phone:229-391-2301
Mailing Address - Fax:
Practice Address - Street 1:334 TIFTON ELDORADO RD
Practice Address - Street 2:
Practice Address - City:TIFTON
Practice Address - State:GA
Practice Address - Zip Code:31794-9497
Practice Address - Country:US
Practice Address - Phone:229-391-2301
Practice Address - Fax:229-386-3221
Is Sole Proprietor?:No
Enumeration Date:2018-10-23
Last Update Date:2020-12-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GALPC010543101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional