Provider Demographics
NPI:1538021225
Name:JOWERS, IVEY (LPC, RN)
Entity type:Individual
Prefix:
First Name:IVEY
Middle Name:
Last Name:JOWERS
Suffix:
Gender:F
Credentials:LPC, RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1498 OAKRIDGE CIR
Mailing Address - Street 2:
Mailing Address - City:DECATUR
Mailing Address - State:GA
Mailing Address - Zip Code:30033-2137
Mailing Address - Country:US
Mailing Address - Phone:404-520-4382
Mailing Address - Fax:
Practice Address - Street 1:1498 OAKRIDGE CIR
Practice Address - Street 2:
Practice Address - City:DECATUR
Practice Address - State:GA
Practice Address - Zip Code:30033-2137
Practice Address - Country:US
Practice Address - Phone:404-520-4382
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-12-01
Last Update Date:2025-12-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GALPC015739101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty