Provider Demographics
NPI:1487939096
Name:CONNIE JONES, LPC, LLC
Entity type:Organization
Organization Name:CONNIE JONES, LPC, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:THERAPIST
Authorized Official - Prefix:MISS
Authorized Official - First Name:CONNIE
Authorized Official - Middle Name:
Authorized Official - Last Name:JONES
Authorized Official - Suffix:
Authorized Official - Credentials:MA, LPC
Authorized Official - Phone:770-862-6088
Mailing Address - Street 1:101 S FAIRFIELD DR
Mailing Address - Street 2:
Mailing Address - City:PEACHTREE CITY
Mailing Address - State:GA
Mailing Address - Zip Code:30269-1188
Mailing Address - Country:US
Mailing Address - Phone:770-862-6088
Mailing Address - Fax:
Practice Address - Street 1:101 S FAIRFIELD DR
Practice Address - Street 2:
Practice Address - City:PEACHTREE CITY
Practice Address - State:GA
Practice Address - Zip Code:30269-1188
Practice Address - Country:US
Practice Address - Phone:770-862-6088
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-10-14
Last Update Date:2011-10-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GALPC006520251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health