JONATHON MICHAEL PRYOR LPC LPCC NPI 1063996619

NPI Information

  • NPI: 1063996619
  • Provider Name: JONATHON MICHAEL PRYOR, LPC, LPCC
  • Classification: Counselor - 101Y00000X
  • Entity Type: Individual
  • Address: 6692 TANGLEWOOD DR
    BLACKSHEAR, GA
    ZIP 31516
  • Phone: (912) 590-2981

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NPI Details

Jonathon Michael Pryor, LPC, LPCC is a counselor in Blackshear, GA. The provider is a provider who is trained and educated in the performance of behavior health services through interpersonal communications and analysis. Training and education at the specialty level usually requires a master's degree and clinical experience and supervision for licensure or certification. Jonathon Michael Pryor, LPC, LPCC NPI is 1063996619. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

6692 TANGLEWOOD DR
BLACKSHEAR, GA
ZIP 31516-530
Phone: (912) 590-2981

The enumeration date for this NPI number is 9/19/2018 and was last updated on 8/19/2024.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1101YP2500XCounselorProfessional16923CALIFORNIANo
2101Y00000XCounselorLPC010482GEORGIAYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
11063996619MEDICAIDGEORGIA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

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