Individual
MR. COLVIN JEFFREY BROGDON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LPC, NCC
Contact information
Practice address
113 BASCOM CT STE C, COLUMBUS, GA 31909-2798
(706) 569-7254
(706) 569-9212
Mailing address
13821 CROSS CREEK RD, UPATOI, GA 31829-1802
(706) 569-9212
(706) 569-9212
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
LPC002957
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
576838803A
—
GA
Enumeration date
09/20/2006
Last updated
06/24/2020
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