Provider Demographics
NPI:1548531494
Name:PEABODY, JAYE LYNN (LAPC, NCC)
Entity type:Individual
Prefix:MS
First Name:JAYE
Middle Name:LYNN
Last Name:PEABODY
Suffix:
Gender:F
Credentials:LAPC, NCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3142 KITTERY DR
Mailing Address - Street 2:
Mailing Address - City:SNELLVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30039-6026
Mailing Address - Country:US
Mailing Address - Phone:770-401-7928
Mailing Address - Fax:
Practice Address - Street 1:2219 SCENIC DR
Practice Address - Street 2:
Practice Address - City:SNELLVILLE
Practice Address - State:GA
Practice Address - Zip Code:30078-3131
Practice Address - Country:US
Practice Address - Phone:770-985-0837
Practice Address - Fax:770-985-6677
Is Sole Proprietor?:No
Enumeration Date:2012-01-24
Last Update Date:2012-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAAPC003302101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional