Mudge, Ian James

Mudge, Ian James is an sole proprietor health care provider with primary practice located at 5320 Cumberland Way , Stone Mountain GA 30087-4211. He recently has 2 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Mental Health, Behavioral Health & Social Service Providers / Professional. Behavioral Health & Social Service Providers / Professional is his primary health care specialty. Mudge, Ian James can be contacted via phone (862) 201-3495.

Contact Information

Primary practice address
5320 Cumberland Way Stone Mountain GA 30087-4211
Phone: (862) 201-3495
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Mental Health 101YM0800X
Behavioral Health & Social Service Providers / Professional 101YP2500X LPC013731 Georgia

Profile Details

NPI number 1700414539
LBN Legal business name Mudge, Ian James
Credentials Licensed Professional Counselor (LPC)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Mar 28th, 2020
Last updated Jul 11th, 2024 - about 2 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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