MS. JACQUELINE LOGAN (NPI# 1710257548) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1710257548 |
| Entity Type | Individual |
| Full Name | MS. JACQUELINE LOGAN |
| Credential | LPC |
| Practice Address |
108 E Ponce De Leon Ave Ste 204 Decatur GA 30030-2512 |
| Mailing Address |
Po Box 373119 Decatur GA 30037-3119 |
| Practice Telephone | 4043828788 |
| Enumeration Date | 2012-01-10 |
| Last Update Date | 2018-03-30 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 101YP2500X |
Counselor Specialization: Professional |
LPC006564 | GA | Behavioral Health & Social Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1972165298 | Jacqueline Logan | Behavioral Analyst | 1902 Fairfax Ave, Cherry Hill, NJ 08003-2007 | 2019-07-08 |
| 1487941852 | Jacqueline Rose Logan | Speech-Language Pathologist | 1500 Oxford Dr, Suite 10, Bethel Park, PA 15102-1823 | 2011-07-06 |
| 1104905108 | Jacqueline Susan Logan | Internal Medicine | 2600 Center St Ne, Oregon State Hospital, Salem, OR 97301 | 2006-11-02 |
| Street Address |
108 E PONCE DE LEON AVE STE 204 |
| City | DECATUR |
| State | GA |
| Zip Code | 30030-2512 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1215056809 | Evan Miller Thomas | Counselor | 108 E Ponce De Leon Ave Ste 204, Decatur, GA 30030-2512 | 2007-03-28 |
| 1861022063 | Carrick Counseling and Consulting, LLC | Social Worker | 108 E Ponce De Leon Ave Ste 204, Decatur, GA 30030-2512 | 2020-01-16 |
| 1881190700 | Rosewood Psychotherapy and Wellness, LLC | Clinic/Center | 108 E Ponce De Leon Ave Ste 204, Decatur, GA 30030-2512 | 2018-03-30 |
| 1720258080 | Christina K Carrick | Social Worker | 108 E Ponce De Leon Ave Ste 204, Decatur, GA 30030-2512 | 2008-03-03 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1801413174 | Pa-c Surgical Assist, LLC | Clinic/Center | 520 W Ponce Leon Ave #1706, Decatur, GA 30030 | 2020-07-02 |
| 1417587478 | Elizabeth Heffron | Acupuncturist | 619b East College Avenue, Decatur, GA 30030 | 2020-01-17 |
| 1669016143 | Atlanta Upper Cervical Chiropractic LLC | Chiropractor | 125 E Trinity Place, Suite #247, Decatur, GA 30030 | 2019-10-29 |
| 1831757418 | Jessica Stewart | Counselor | 755 Commerce Dr Ste 903, Decatur, GA 30030 | 2019-05-30 |
| 1699238733 | Dinah Augustin | Registered Nurse | 1458 Church St., Unit B, Decatur, GA 30030 | 2019-04-06 |
| 1093284291 | Eliza Segell | Social Worker | 165 Dekalb Industrial Way Ste D-1, Decatur, GA 30030 | 2018-11-16 |
| 1912476466 | Positive Impact Health Centers, Inc. | Pharmacy | 523 Church Street, Suite B, Decatur, GA 30030 | 2018-11-14 |
| 1932685096 | T2 Imaging | Radiology | 1376 Church Street, Suite 100, Decatur, GA 30030 | 2018-07-12 |
| 1992292858 | Keeanna M Powell | Counselor | Agape Transformation Practice, 235 E. Ponce De Leon Ave Suite 103, Decatur, GA 30030 | 2018-04-17 |
| 1780185488 | Solutions Ae Inc | Counselor | One West Square Court, Suite 710, Decatur, GA 30030 | 2018-02-27 |
| Find all providers in zip 30030 | ||||
| Taxonomy Code | 101YP2500X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Counselor |
| Specialization | Professional |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1598363392 | Kimberly Swanson | Counselor | 311 West Hill Street, Decatur, GA 30030-4319 | 2020-10-14 |
| 1083228050 | Lasonja D Carter | Counselor | 2920 Frost Dr Sw, Decatur, AL 35603-4531 | 2020-09-07 |
| 1154935468 | Nick Hersey | Counselor | 1924 Clairmont Rd Ste 50, Decatur, GA 30033-3450 | 2020-09-03 |
| 1760095814 | Potters Touch Counseling Inc. | Counselor | 4150 Snapfinger Woods Dr Ste 100, Decatur, GA 30035-3417 | 2020-08-28 |
| 1407464563 | Starre Cannon | Counselor | 3183 Tarian Way, Decatur, GA 30034-5539 | 2020-07-15 |
| 1164040713 | Bethany Cecelia Merrett | Counselor | 223 Kathryn Ave, Decatur, GA 30030-5017 | 2020-07-09 |
| 1053939090 | Virtue Speaks LLC | Counselor | 4150 Snapfinger Woods Dr Ste 104d, Decatur, GA 30035-3417 | 2020-07-07 |
| 1821619842 | Knitikia Gross | Counselor | 436 Eastwyck Cir, Decatur, GA 30032-6694 | 2020-04-30 |
| 1063033074 | Marcy Renee Jefferson-watkins | Counselor | 2126 6th Ave Se Ste 208, Decatur, AL 35601-6547 | 2020-04-30 |
| 1790304004 | Tonia D Morris | Counselor | 3006 Western Sunset Ct, Decatur, GA 30034-1692 | 2020-04-16 |
| Find all providers in DECATUR | ||||
Please comment or provide details below to improve the information on MS. JACQUELINE LOGAN.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.