IndividualActive
Andrew Provence, LPC
NPI 1114079159 · Professional Counselor · Griffin, GA
Provider details
- NPI number
- 1114079159
- Entity type
- Individual
- Primary specialty
- Professional CounselorBehavioral Health & Social Service Providers
- Credential
- LPC
- Sex
- Male
- Sole proprietor
- No
- License
- LPC003592 (GA)
Practice location
2000 W Mcintosh Rd
Griffin, GA 30223-6265
Phone: (678) 688-3133
Fax: (678) 688-3134
Mailing address
2000 W Mcintosh Rd
Griffin, GA 30223-6265
Registry dates
- Enumerated
- 2007-01-18
- Last updated
- 2007-07-08
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.