Provider Demographics
NPI:1134530249
Name:JONES, ANNA (LPC, CPCS, LCPC, CAC)
Entity type:Individual
Prefix:
First Name:ANNA
Middle Name:
Last Name:JONES
Suffix:
Gender:F
Credentials:LPC, CPCS, LCPC, CAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3440 RAINEY AVE
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30354-1310
Mailing Address - Country:US
Mailing Address - Phone:404-354-6370
Mailing Address - Fax:
Practice Address - Street 1:617 N CENTRAL AVE
Practice Address - Street 2:
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30354-1917
Practice Address - Country:US
Practice Address - Phone:404-907-0946
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-05-12
Last Update Date:2014-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD0381101YA0400X
GA3100101YP2500X
MD1164101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)