Provider Demographics
NPI:1104703644
Name:ROSS, JAYLIN JENE (LAPC)
Entity type:Individual
Prefix:MISS
First Name:JAYLIN
Middle Name:JENE
Last Name:ROSS
Suffix:
Gender:F
Credentials:LAPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:915 HILL PARK STE 100B
Mailing Address - Street 2:
Mailing Address - City:MACON
Mailing Address - State:GA
Mailing Address - Zip Code:31201-1929
Mailing Address - Country:US
Mailing Address - Phone:478-305-7139
Mailing Address - Fax:
Practice Address - Street 1:915 HILL PARK STE 100B
Practice Address - Street 2:
Practice Address - City:MACON
Practice Address - State:GA
Practice Address - Zip Code:31201-1929
Practice Address - Country:US
Practice Address - Phone:478-305-7139
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-08-18
Last Update Date:2025-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAAPC009864101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional