Individual
JONATHON MICHAEL PRYOR
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LPC, LPCC
Contact information
Practice address
6692 TANGLEWOOD DR, BLACKSHEAR, GA 31516-7530
(912) 590-2981
Mailing address
PO BOX 1884, WAYCROSS, GA 31502-1884
(912) 590-2981
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
LPC010482
GA
101YP2500X
Professional Counselor
16923
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1063996619
—
GA
Enumeration date
09/19/2018
Last updated
08/19/2024
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