Provider Demographics
NPI:1588732457
Name:GIANCOLA-BOLTON, JOYCE ANN (LPC)
Entity type:Individual
Prefix:
First Name:JOYCE
Middle Name:ANN
Last Name:GIANCOLA-BOLTON
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:120 BRAMBLE OAK DR
Mailing Address - Street 2:
Mailing Address - City:WOODSTOCK
Mailing Address - State:GA
Mailing Address - Zip Code:30188-4700
Mailing Address - Country:US
Mailing Address - Phone:770-926-3224
Mailing Address - Fax:770-517-4571
Practice Address - Street 1:412 E 1ST ST
Practice Address - Street 2:
Practice Address - City:ROME
Practice Address - State:GA
Practice Address - Zip Code:30161-3104
Practice Address - Country:US
Practice Address - Phone:706-235-6990
Practice Address - Fax:770-517-4571
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA002052101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health