Haines-Pruitt, Jennifer

Haines-Pruitt, Jennifer is an individual health care provider with primary practice located at 561 Thornton Rd Ste R , Lithia Springs GA 30122-1558. She recently has only one registered license in Behavioral Health & Social Service Providers / Mental Health, which is considered as her primary health care specialty. Haines-Pruitt, Jennifer can be contacted via phone (678) 653-6314.

Contact Information

Primary practice address
561 Thornton Rd Ste R Lithia Springs GA 30122-1558
Phone: (678) 653-6314
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Mental Health 101YM0800X LPC007776 Georgia

Profile Details

NPI number 1962948687
LBN Legal business name Haines-Pruitt, Jennifer
Credentials Licensed Professional Counselor (LPC)
Entity Individual
Sole proprietor 1 No
Enumeration date Jan 19th, 2017
Last updated Sep 14th, 2018 - about 6 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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Identifiers

StateTypeNumberIssuer
All States NPI 1962948687 NPPES
Georgia MEDICAID 1174512966

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