Childress, Jacqueline S

Childress, Jacqueline S is an sole proprietor health care provider with primary practice located at 3100 Crepe Myrtle Ct Apt B , Albany GA 31721-6208. She recently has 2 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Counselor, Behavioral Health & Social Service Providers / Mental Health. Behavioral Health & Social Service Providers / Mental Health is her primary health care specialty. Childress, Jacqueline S can be contacted via phone (229) 809-2674.

Contact Information

Primary practice address
3100 Crepe Myrtle Ct Apt B Albany GA 31721-6208
Phone: (229) 809-2674
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Counselor 101Y00000X APC004295 Georgia
Behavioral Health & Social Service Providers / Mental Health 101YM0800X LPC008933 Georgia

Profile Details

NPI number 1205253630
LBN Legal business name Childress, Jacqueline S
Credentials ME.D., LAPC
Entity Individual
Sole proprietor 1 Yes
Enumeration date Mar 24th, 2014
Last updated Aug 25th, 2016 - about 8 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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