Dewayne C Grant

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

LPC006829 Issued in GA

Practice address

124 S Main St
Suite 2N
Jonesboro, GA 30236-3599

Phone

(678) 215-8705

Fax

(770) 898-4385

NPI assigned

Aug 9, 2013

Sex

Male

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 3

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Nevaeh Consulting, LLC

  • Mental Health Counselor
  • Jonesboro, GA
  • NPI 1013459957

  Addiction (Substance Use Disorder)

  NPD (past) Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1376006400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1438560000000",
    "number": "1437582723",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "417 AKERS DR",
            "city": "MCDONOUGH",
            "state": "GA",
            "postal_code": "302538382",
            "telephone_number": "678-215-8705",
            "fax_number": "770-898-4385"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "124 S MAIN ST",
            "address_2": "SUITE 2N",
            "city": "JONESBORO",
            "state": "GA",
            "postal_code": "302363599",
            "telephone_number": "678-215-8705",
            "fax_number": "770-898-4385"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRANT",
        "first_name": "DEWAYNE",
        "middle_name": "C",
        "name_prefix": "Mr.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2013-08-09",
        "last_updated": "2015-08-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "GA",
            "license": "LPC006829",
            "primary": true
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "GA",
            "license": "LPC 006829",
            "primary": false
        },
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "GA",
            "license": "LPC 006829",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "003160809A",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "003152990A",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Good Ground Development Center
• Alan J. Gottlieb, MD
• Joanne Govan, MSW
• GR8-Xpressions Behavioral Health, LLC.
• Grace Personal Care Home Living Inc
• Diane Gray, RN
• Albertina Latrice Green, MA, LPC
• Ayana T Green, LPC
• Marla C Green, FNP-C
• Eunece Greer, L.P.C., NCC, MAC

• Professional Counselor in Jonesboro, GA
• Providers in Jonesboro, GA by specialty
• Professional Counselor in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 3, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.