Deidre Detloff

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

Practice address

1518 Airport Rd
Hinesville, GA 31313-9439

Phone

(912) 559-5536

NPI assigned

Jul 15, 2021

Sex

Female

Sole proprietor

Yes

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

Practice roles

Locations

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.

• Malinda Graham and Associates

  • Community/Behavioral Health Agency
  • Hinesville, GA
  • NPI 1689859340
  NPD

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

{
    "created_epoch": "1626307200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1626307200000",
    "number": "1629640891",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "616 UNION ST",
            "city": "BRUNSWICK",
            "state": "GA",
            "postal_code": "315208213",
            "telephone_number": "912-269-5009"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1518 AIRPORT RD",
            "city": "HINESVILLE",
            "state": "GA",
            "postal_code": "313139439",
            "telephone_number": "912-559-5536"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DETLOFF",
        "first_name": "DEIDRE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-07-15",
        "last_updated": "2021-07-15",
        "certification_date": "2021-07-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Cara Denise Dehaney
• Shawnacy Unique Delao- Walker, RBT
• Anna Delong
• Sandy Deniz
• Pallav Desai
• Atul M. Devani, MD
• Devine Trinity Personal Care Home, Inc.
• Holly Ann Dickens, RBT
• Diversity Health Center Inc
• Diversity Health Center Inc

• Mental Health Counselor in Hinesville, GA
• Providers in Hinesville, 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 Jul 15, 2021; 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.