Individual provider · Type 1 NPI

Jon Patrick Costales, LPC

Professional Counselor · Canton, GA

NPI number 1902361553 Active

Practice location

310 Paper Trail Way Ste 106
Canton, GA 30115-5204

Mailing address

7339 Reinhardt College Pkwy
Waleska, GA 30183-2901

Specialties and licenses

TaxonomyCodeLicense
Professional Counselor Primary 101YP2500XLPC009867 (GA)

Professional Counselor: Definition to come...

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About NPI 1902361553

Jon Patrick Costales, LPC's National Provider Identifier is 1902361553, issued on Feb 7, 2019. The primary taxonomy on file is Professional Counselor (101YP2500X), and the practice location is in Canton, GA. The record was last updated on Feb 7, 2019.