Deanna Ruth Dennis, LPC
Individual provider Active NPI Professional Counselor · Cedartown, GA
NPI 1124244983 · NPPES record last updated Aug 22, 2011
Key facts
- NPI
- 1124244983
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Professional Counselor 101YP2500X
- License
- LPC005515 (GA)
- Practice address
- 180 Wateroak Drive
Cedartown, GA 30125-2095 - Phone
- (706) 748-2225
- Fax
- (706) 749-0939
- NPI assigned
- Apr 18, 2007
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 2
Medicare Care Compare profile
- Specialty
- Mental Health Counselor
- Education
- Other, 2005
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
- The Northrop Connection, LLC
Practice addresses (Care Compare)
702 W Memorial Dr
Dallas, GA 30132-4122
Phone (678) 332-7955
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in GA
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: No · Power mobility devices: No · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20240306003536 | GA | Practitioner - Mental Health Counselor | 3577909068 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| LPC005515 | GA | MD | Professional Counselor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| The Northrop Connection, LLC | Current |
Accepting new patients | |
| Highland Rivers CSB | Past | Accepting new patients |
Locations
702 W Memorial Dr
Dallas, GA 30132
Phone (678) 332-7955
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | LPC005515 | GA | Yes |
Addresses
Primary practice location
180 Wateroak Drive
Cedartown, GA 30125-2095
Mailing address
1620 Hickory Street
Suite 404
Dalton, GA 30720-2312
Phone (706) 270-5033
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| LPC005515 | Other | GA | LICENSE |
Other providers in Cedartown, GA
- Julaine B Cross
- Sharon Crowder
- Katheleen Crump
- Angela Davis
- Leslie Deems
- Kendall Dostart
- Richard Joseph Dowling
- Dva Renal Healthcare Inc
- Amanda B Dworkin
- Karen Ann Eberhart
All providers in Cedartown, GA · Professional Counselor in Georgia
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 22, 2011. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.