Male or Other

Mr. Jeremiah Grogg MS, LPC

Professional Counselor in Evans, GA(View on Map)

Full Name

Mr. Jeremiah Grogg MS, LPC

NPI Number

1578017166

NPI Type

Individual Provider

Gender

Male

Enumeration Date

08/11/2016

Specialties

(Taxonomies)

Code

101YP2500X

Primary Taxonomy

Yes

Licenses

State

Georgia

License Number

LPC009114

Contact
Information

Purpose

Mailing
Location

Address

601 N BELAIR SQ STE 2
601 N BELAIR SQ STE 2

City

Evans
Evans

State

GA
GA

Postal Code

30809
30809-0518

Country

US
US

Telephone Number

(706) 836-1195
(706) 836-1195

Identifiers

Identifier

003181469A

Identifier State

GA

Identifier Issuer

Unknown

Provider data last refreshed from NPPES NPI registry on 11/19/2024

Data last updated by provider on 07/21/2022

Provider Address

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