Provider Demographics
NPI:1679983472
Name:TROY, JAMIKA (LPC)
Entity type:Individual
Prefix:MRS
First Name:JAMIKA
Middle Name:
Last Name:TROY
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:101 BECKETT LN STE 505
Mailing Address - Street 2:
Mailing Address - City:FAYETTEVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30214-7160
Mailing Address - Country:US
Mailing Address - Phone:770-605-8225
Mailing Address - Fax:
Practice Address - Street 1:101 BECKETT LN STE 505
Practice Address - Street 2:
Practice Address - City:FAYETTEVILLE
Practice Address - State:GA
Practice Address - Zip Code:30214-7160
Practice Address - Country:US
Practice Address - Phone:770-605-8225
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-05-01
Last Update Date:2014-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GALPC005389101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional