Provider Demographics
NPI:1598418469
Name:JONES, SAMUEL CHASE (LPC, CPCS)
Entity type:Individual
Prefix:
First Name:SAMUEL
Middle Name:CHASE
Last Name:JONES
Suffix:
Gender:M
Credentials:LPC, CPCS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:140 WILLS LN
Mailing Address - Street 2:
Mailing Address - City:ALPHARETTA
Mailing Address - State:GA
Mailing Address - Zip Code:30009-1837
Mailing Address - Country:US
Mailing Address - Phone:404-395-0282
Mailing Address - Fax:
Practice Address - Street 1:4200 NORTHSIDE PKWY NW
Practice Address - Street 2:BUILDING 14, SUITE 100
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30327-3032
Practice Address - Country:US
Practice Address - Phone:404-436-1725
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-02-01
Last Update Date:2022-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GALPC007782101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health