Provider Demographics
NPI:1548301484
Name:CLANCE, JEFFERY WAYNE (LPC)
Entity type:Individual
Prefix:DR
First Name:JEFFERY
Middle Name:WAYNE
Last Name:CLANCE
Suffix:
Gender:M
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:188 SOUTHMONT DR NE
Mailing Address - Street 2:
Mailing Address - City:CALHOUN
Mailing Address - State:GA
Mailing Address - Zip Code:30701-9537
Mailing Address - Country:US
Mailing Address - Phone:706-934-6164
Mailing Address - Fax:706-625-0195
Practice Address - Street 1:188 SOUTHMONT DR NE
Practice Address - Street 2:
Practice Address - City:CALHOUN
Practice Address - State:GA
Practice Address - Zip Code:30701-9537
Practice Address - Country:US
Practice Address - Phone:706-934-6164
Practice Address - Fax:706-625-0195
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-12
Last Update Date:2025-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GALPC003141101Y00000X, 101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor
Not Answered101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional