Provider Demographics
NPI:1104952126
Name:KERR, JONATHAN CHARLES (LPC)
Entity type:Individual
Prefix:MR
First Name:JONATHAN
Middle Name:CHARLES
Last Name:KERR
Suffix:
Gender:M
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:644 ACRE EST
Mailing Address - Street 2:
Mailing Address - City:TOCCOA
Mailing Address - State:GA
Mailing Address - Zip Code:30577-8137
Mailing Address - Country:US
Mailing Address - Phone:706-244-0245
Mailing Address - Fax:
Practice Address - Street 1:325 CHAPEL DR
Practice Address - Street 2:
Practice Address - City:TOCCOA FALLS
Practice Address - State:GA
Practice Address - Zip Code:30598-9600
Practice Address - Country:US
Practice Address - Phone:706-282-0824
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-26
Last Update Date:2013-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GALPC0003513101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health