Dewanna Chambliss
Individual provider Active NPI Clinical Social Worker · Canton, MS
NPI 1770143745 · NPPES record last updated Jun 20, 2019
Key facts
- NPI
- 1770143745
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Clinical Social Worker 1041C0700X
- License
- C7801 (MS)
- Practice address
- 1171 Hart St
Canton, MS 39046-4805 - Phone
- (601) 859-9888
- NPI assigned
- Jun 20, 2019
- Sex
- Female
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| C7801 | MS | MD | Clinical Social Worker |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | C7801 | MS | Yes |
Addresses
Primary practice location
1171 Hart St
Canton, MS 39046-4805
Mailing address
313 Willow Run
Pearl, MS 39208-8075
Other providers in Canton, MS
- Cantons Physician Group
- Capital Emergency Physicians Madison PLLC
- Michael Caples
- Jessica Carson
- Catx, Inc
- Kajuandra Chandler-McDuffy
- Angela L. Chandler
- Takita Chaney
- Ruth A Chong
- Mattie Clark
All providers in Canton, MS · Clinical Social Worker in Mississippi
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 20, 2019. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.