Provider Demographics
NPI:1255873709
Name:FONDI, DOROTHY A (MS, LPC, CPCS, MAC)
Entity type:Individual
Prefix:
First Name:DOROTHY
Middle Name:A
Last Name:FONDI
Suffix:
Gender:F
Credentials:MS, LPC, CPCS, MAC
Other - Prefix:
Other - First Name:DOROTHY
Other - Middle Name:A
Other - Last Name:FORTUCHANG
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LPC, CPCS, MAC, NCC
Mailing Address - Street 1:157 SMITH ST
Mailing Address - Street 2:
Mailing Address - City:JONESBORO
Mailing Address - State:GA
Mailing Address - Zip Code:30236-3546
Mailing Address - Country:US
Mailing Address - Phone:770-473-2418
Mailing Address - Fax:770-473-9772
Practice Address - Street 1:853 BATTLECREEK RD
Practice Address - Street 2:
Practice Address - City:JONESBORO
Practice Address - State:GA
Practice Address - Zip Code:30236-1919
Practice Address - Country:US
Practice Address - Phone:770-473-2620
Practice Address - Fax:770-478-8722
Is Sole Proprietor?:No
Enumeration Date:2016-11-15
Last Update Date:2019-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA508802101YA0400X
GALPC007651101YM0800X, 101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health