Individual
MR. JACK LENFORD ABERNATHY JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MS, NCC, CCMHC, LPC
Contact information
Practice address
900 CIRCLE 75 PKWY SE, SUITE 1435, ATLANTA, GA 30339-3905
(404) 895-0990
(770) 485-5906
Mailing address
900 CIRCLE 75 PKWY SE, SUITE 1435, ATLANTA, GA 30339-3905
(404) 895-0990
(770) 485-5906
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
LPC007969
GA
101YP2500X
Professional Counselor
Primary
LPC007969
GA
Other
Enumeration date
10/09/2013
Last updated
11/05/2016
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