JERRUROD PAUL JR.
NPI 1508422726
Counselor - Professional in Brookhaven, GA
Active since May 13, 2019
About Jerrurod Paul Jr. NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
JERRUROD PAUL JR. (NPI 1508422726) is an individual professional provider in Brookhaven, Georgia, licensed in Georgia (LPC014551) and active in the NPI registry since May 2019.
NPPES Registry Identity
NPI1508422726
Entity TypeIndividualMale
Primary Taxonomy101YP2500X
Provider Legal NameJERRUROD PAUL JR.
Location Address2611 REDDING RD NEBrookhaven, GA 30319-2905
Mailing Address2611 Redding Rd NeBrookhaven, GA 30319-2905 · (770) 882-7091
Phone(770) 882-7091
Sole ProprietorNo
Enumeration DateMay 13, 2019
Last NPPES UpdateJuly 23, 20242 updates tracked since enumeration
NPPES CertifiedJuly 23, 2024
✔ NPI 1508422726 is a valid, active identifier and passes the ISO check-digit test.
Specialties & Licenses 2
★ Primary SpecialtyCounselor · ProfessionalBehavioral Health & Social Service Providers
Taxonomy Code101YP2500X
License✔ Licensed in GA · LPC014551
Also ListedBehavior TechnicianTaxonomy 106S00000X · License RBT-19-85867 (GA), 19-85867 (GA)
2611 REDDING RD NE, Brookhaven, GA 30319
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1508422726, enumerated as an "individual" on May 13, 2019.
The provider is located at 2611 REDDING RD NE BROOKHAVEN, GA 30319 and the phone number is (770) 882-7091.
Counselor with taxonomy code 101YP2500X and a focus in Professional.
