Provider Demographics
NPI:1558809822
Name:PROW, ERNEST R III (LPC)
Entity type:Individual
Prefix:
First Name:ERNEST
Middle Name:R
Last Name:PROW
Suffix:III
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 1:145 DEIDRE DR
Mailing Address - Street 2:
Mailing Address - City:ATHENS
Mailing Address - State:GA
Mailing Address - Zip Code:30607-1335
Mailing Address - Country:US
Mailing Address - Phone:706-207-3438
Mailing Address - Fax:
Practice Address - Street 1:11 BUSINESS CENTER DR STE 205
Practice Address - Street 2:
Practice Address - City:EASTANOLLEE
Practice Address - State:GA
Practice Address - Zip Code:30538-3254
Practice Address - Country:US
Practice Address - Phone:706-207-3438
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-02-07
Last Update Date:2024-07-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GALPC011378101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health