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Active NPI 1710257548 Individual Practitioner Female Practitioner

Jacqueline Logan , LPC

Counselor - Professional • Decatur, GA

Professional Overview & Biography Verified Profile Summary

Jacqueline Logan, LPC is a registered healthcare professional specializing in Counselor - Professional in Decatur, GA. Practice services are available at 108 E PONCE DE LEON AVE STE 204 under active NPI credentials.

Practice Location & Contact Primary Location

Practice Address

108 E Ponce De Leon Ave Ste 204

Decatur, GA 300302512

Telephone 4043828788
Associated Practice Facility / Clinic
🏢 Rosewood Psychotherapy And Wellness, Llc Facility NPI 1881190700

Specialty Benchmarks & Practice Insights

Comparative analytics for Counselor - Professional in Decatur, GA

Active Practitioner
Practitioner Clinical Experience
Active
City Avg: 15.1 Yrs
State Avg: 15.6 Yrs
Regional Practice Density
243 Specialists

Practicing in Decatur, GA (6655 Statewide)

Telehealth Adoption Rate
4.1% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount
67.4% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Medical Specialties & State Licenses

Counselor - Professional Primary Specialty

NUCC Taxonomy Code: 101YP2500X

State License GA LPC006564

Definition to come...

Practice Associates & Co-Workers

Healthcare professionals and specialists practicing at this location or sharing practice phone/fax

1 Associated Practitioners
NPI 1215056809

Doctor of Psychology (Psy.D.)

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

9 Historical Events
📍
Updated Practice Location March 30, 2018

Registered at 108 E PONCE DE LEON AVE STE 204, DECATUR, GA 300302512 (Tel: 4043828788)

📍
Updated Business Mailing Address March 30, 2018

Registered at PO BOX 373119, DECATUR, GA 300373119

👤
Provider Name / Credentials Updated March 30, 2018

Recorded as JACQUELINE LOGAN, LPC

✅
NPI Profile Active November 16, 2012

NPI status registered as active in NPPES database

📍
Updated Practice Location November 16, 2012

Registered at 501 PULLIAM ST SW, SUITE 407, ATLANTA, GA 303122755 (Tel: 4044747021)

📍
Updated Business Mailing Address November 16, 2012

Registered at 501 PULLIAM ST SW, SUITE 407, ATLANTA, GA 303122755

👤
Provider Name / Credentials Updated November 16, 2012

Recorded as JACQUELINE WIAFE, LPC

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) November 16, 2012

Counselor (License #LPC006564 in GA)

🟢
Initial NPI Registration & Enumeration January 10, 2012

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

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NPI Administrative Meta

NPI Number: 1710257548
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: January 10, 2012
Last Update: March 30, 2018
Sole Proprietor: Yes
Update or Correct Profile

Mailing Address

Po Box 373119

Decatur, GA 300373119

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).
⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.