Provider Demographics
NPI:1588991517
Name:WITHROW, JANICE C (LPC)
Entity type:Individual
Prefix:
First Name:JANICE
Middle Name:C
Last Name:WITHROW
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:7580 BRIAR CREST CT
Mailing Address - Street 2:
Mailing Address - City:RIVERDALE
Mailing Address - State:GA
Mailing Address - Zip Code:30296-3380
Mailing Address - Country:US
Mailing Address - Phone:678-851-6817
Mailing Address - Fax:404-996-3488
Practice Address - Street 1:920 DANNON VW SW STE 3202
Practice Address - Street 2:
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30331-2161
Practice Address - Country:US
Practice Address - Phone:404-346-3471
Practice Address - Fax:404-346-3473
Is Sole Proprietor?:No
Enumeration Date:2009-11-12
Last Update Date:2010-01-22
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
GALPC005442101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional