Individual
JASON PAUL BENTON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LPC
Contact information
Practice address
1090 FOUNDERS BLVD STE B, ATHENS, GA 30606-6163
(706) 549-3606
Mailing address
196 SCOGGINS DR, DEMOREST, GA 30535-5354
(706) 894-3700
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
LPC007064
GA
Other
Enumeration date
03/07/2018
Last updated
06/07/2021
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