Provider Demographics
NPI:1902147432
Name:JONES, CASANDRA MICHELL (MS, LPC)
Entity Type:Individual
Prefix:MRS
First Name:CASANDRA
Middle Name:MICHELL
Last Name:JONES
Suffix:
Gender:F
Credentials:MS, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 321
Mailing Address - Street 2:
Mailing Address - City:MCDONOUGH
Mailing Address - State:GA
Mailing Address - Zip Code:30253-0321
Mailing Address - Country:US
Mailing Address - Phone:561-255-3783
Mailing Address - Fax:866-945-9685
Practice Address - Street 1:110 EAGLE SPRING DR
Practice Address - Street 2:SUITE C
Practice Address - City:STOCKBRIDGE
Practice Address - State:GA
Practice Address - Zip Code:30281-6488
Practice Address - Country:US
Practice Address - Phone:561-255-3783
Practice Address - Fax:866-945-9685
Is Sole Proprietor?:Yes
Enumeration Date:2013-03-07
Last Update Date:2013-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GALPC006239101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional