Individual
JEROME D. DINGLE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LCSW
Contact information
Practice address
2022 15TH AVE, COLUMBUS, GA 31901-1699
(706) 649-6500
(706) 649-6521
Mailing address
2022 15TH AVE, COLUMBUS, GA 31901-1699
(706) 496-5006
(706) 649-6521
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
CSW008544
GA
101YM0800X
Mental Health Counselor
Primary
CSW008544
GA
101YM0800X
Mental Health Counselor
—
—
101YP2500X
Professional Counselor
CSW008544
GA
Other
Enumeration date
08/15/2019
Last updated
04/16/2023
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