Provider Demographics
NPI:1902954423
Name:JONES, MICHELLA CATHERINE (LPC)
Entity Type:Individual
Prefix:MS
First Name:MICHELLA
Middle Name:CATHERINE
Last Name:JONES
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8697 HOSPITAL DR
Mailing Address - Street 2:
Mailing Address - City:DOUGLASVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30134-2263
Mailing Address - Country:US
Mailing Address - Phone:678-838-9336
Mailing Address - Fax:678-838-3619
Practice Address - Street 1:9331 E CARROLL RD
Practice Address - Street 2:
Practice Address - City:WHITESBURG
Practice Address - State:GA
Practice Address - Zip Code:30185-2021
Practice Address - Country:US
Practice Address - Phone:770-577-7571
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GALPC003228101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor