| John T Doheny Iii Lpc | |
|
2901 University Ave Suite 41 Columbus GA 31907-7606 | |
| (706) 575-1833 | |
| (706) 507-9012 |
| Full Name | John T Doheny Iii Lpc |
|---|---|
| Speciality | Counselor - Mental Health |
| Location | 2901 University Ave, Columbus, Georgia |
| Authorized Official Name and Position | John Doheny (OWNER/OPERATOR) |
| Authorized Official Contact | 7065751833 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| John T Doheny Iii Lpc Po Box 5754 Suite 41 Columbus GA 31906-0754 Ph: (706) 575-1833 | John T Doheny Iii Lpc 2901 University Ave Suite 41 Columbus GA 31907-7606 Ph: (706) 575-1833 |
| NPI Number | 1043587595 |
|---|---|
| Provider Enumeration Date | 11/29/2011 |
| Last Update Date | 11/29/2011 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1043587595 | NPI | - | NPPES |
| 746440550A | Medicaid | GA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YA0400X | Counselor - Addiction (substance Use Disorder) | 12786 (* (Not Available)) | Secondary |
| 101YM0800X | Counselor - Mental Health | 003696 (Georgia) | Primary |
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