Individual provider · NPI-1

Jack Lenford Abernathy Jr., MS, NCC, CCMHC, LPC

Counselor, Professional · Atlanta, GA

NPI number1235566126
StatusActive
Last updated in NPPESNov 5, 2016

Details

NPI
1235566126
Entity type
Individual (NPI-1)
Name
Mr. Jack Lenford Abernathy Jr.
Credential
MS, NCC, CCMHC, LPC
Sex
Male
Sole proprietor
No
Enumeration date
Oct 9, 2013
Last updated
Nov 5, 2016

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
101YP2500X Counselor, ProfessionalLPC007969GAYes
101YM0800X Counselor, Mental HealthLPC007969GA

Practice location

900 Circle 75 Pkwy Se
Suite 1435
Atlanta, GA 30339-3905

Phone 404-895-0990 · Fax 770-485-5906

Mailing address

900 Circle 75 Pkwy Se
Suite 1435
Atlanta, GA 30339-3905

Phone 404-895-0990 · Fax 770-485-5906

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