Provider Demographics
NPI:1285513192
Name:HEADLEE-JONES, KATHRYN POTTER (LMSW)
Entity type:Individual
Prefix:MRS
First Name:KATHRYN
Middle Name:POTTER
Last Name:HEADLEE-JONES
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:KATHRYN
Other - Middle Name:POTTER
Other - Last Name:HEADLEE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LMSW
Mailing Address - Street 1:800 OLD ROSWELL LAKES PKWY STE 220
Mailing Address - Street 2:
Mailing Address - City:ROSWELL
Mailing Address - State:GA
Mailing Address - Zip Code:30076-1667
Mailing Address - Country:US
Mailing Address - Phone:470-400-0830
Mailing Address - Fax:
Practice Address - Street 1:800 OLD ROSWELL LAKES PKWY STE 220
Practice Address - Street 2:
Practice Address - City:ROSWELL
Practice Address - State:GA
Practice Address - Zip Code:30076-1667
Practice Address - Country:US
Practice Address - Phone:470-400-0830
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-08-27
Last Update Date:2025-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAMSW010277104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker