Individual provider · Type 1 NPI

Samantha Liverpool-Jackson

Mental Health Counselor · Conyers, GA

NPI number 1497419683 Active

Practice location

1387 Mourning Dove Dr SW
Conyers, GA 30094-5761

Call (404) 593-0516 Map

Mailing address

2215 Exchange Pl SE
Conyers, GA 30013-6723

Specialties and licenses

TaxonomyCodeLicense
Mental Health Counselor Primary 101YM0800X010154 (GA)

Mental Health Counselor: Definition to come...

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About NPI 1497419683

Samantha Liverpool-Jackson's National Provider Identifier is 1497419683, issued on Oct 25, 2021. The primary taxonomy on file is Mental Health Counselor (101YM0800X), and the practice location is in Conyers, GA. The record was last updated on Apr 14, 2026.