Provider Demographics
NPI:1154700896
Name:BURROUGHS & JONES COUNSELING AND CONSULTING, LLC
Entity type:Organization
Organization Name:BURROUGHS & JONES COUNSELING AND CONSULTING, LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:E
Authorized Official - Last Name:BURROUGHS
Authorized Official - Suffix:
Authorized Official - Credentials:MBA
Authorized Official - Phone:229-392-4457
Mailing Address - Street 1:PO BOX 2036
Mailing Address - Street 2:
Mailing Address - City:TIFTON
Mailing Address - State:GA
Mailing Address - Zip Code:31793-2036
Mailing Address - Country:US
Mailing Address - Phone:480-748-9534
Mailing Address - Fax:229-382-8353
Practice Address - Street 1:1216 DAWSON RD STE 110
Practice Address - Street 2:
Practice Address - City:ALBANY
Practice Address - State:GA
Practice Address - Zip Code:31707-3800
Practice Address - Country:US
Practice Address - Phone:229-392-4457
Practice Address - Fax:229-382-8353
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-05-27
Last Update Date:2024-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GALPC008251101YP2500X, 251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Multi-Specialty
No251S00000XAgenciesCommunity/Behavioral HealthGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA003157272AMedicaid
GAA922342OtherAMERICAN HEALTHCARE ACADEMY (CPR AND AED CERTIFICATION)
GA6426956OtherAMERICAN COUNSELING ASSOCIATION (ACA MEMBERSHIP)
GANCC668043OtherNATIONAL BOARD OF CERTIFIED COUNSELORS (NCC CERTIFICATION)
GA2079OtherLPCAGA (CERTIFIED PROFESSIONAL COUNSELOR SUPERVISOR - CPCS)
GA79770372OtherDUN & BRADSTREET (DUNS ID#)
GALPC008251OtherGEORGIA COMPOSITE BOARD OF PROFESSIONAL COUNSELORS, SWS, & MFTS (LPC LICENSE)
GA1835OtherHIGH IMPACT TRAINING AND COUNSELING, INC. (CAMS-II CERTIFICATION)
GA020720170OtherTHE JOHN PRAED FOUNDATION (ANSA GEORGIA CERTIFICATION)
GA30967662OtherTHE LICENSED PROFESSIONAL COUNSELORS ASSOCIATION OF GEORGIA (LPCAGA MEMBERSHIP)
GA13509476OtherCAQH PROVIEW PROVIDER REGISTRY (CAQH PROVIDER #)
GA641060OtherGEORGIA PROFESSIONAL STANDARDS COMMISSION (CTFD EDUCATOR IN SCHOOL COUNSELING)