Keji Ita, LMSW

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

MSW012080 Issued in GA

Practice address

2801 Buford Hwy NE Ste 550B
Brookhaven, GA 30329-2124

Phone

(770) 912-0234

NPI assigned

Dec 20, 2024

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1734652800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1734652800000",
    "number": "1447068648",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5564 TRACE VIEWS DR",
            "city": "NORCROSS",
            "state": "GA",
            "postal_code": "300711436",
            "telephone_number": "470-384-3790"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2801 BUFORD HWY NE STE 550B",
            "city": "BROOKHAVEN",
            "state": "GA",
            "postal_code": "303292124",
            "telephone_number": "770-912-0234"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ITA",
        "first_name": "KEJI",
        "credential": "LMSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-12-20",
        "last_updated": "2024-12-20",
        "certification_date": "2024-12-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "GA",
            "license": "MSW012080",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Intown Speech Therapy, LLC
• Michael Irr
• Jessica Helton Irungu, PHARMD
• Nicolas Isaac, PHARMD
• Haruki Ishii, MD
• Jasmine Ivie
• J. Griffiths Dentistry, LLC
• Amanda Jackson, OTR/L CPAM
• Judy Jackson
• Mackenzie Lynn Jacobson, BA, RBT

• Mental Health Counselor in Brookhaven, GA
• Providers in Brookhaven, GA by specialty
• Mental Health Counselor in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 20, 2024; 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.