Jimmie Denson

Individual provider Active NPI Community/Behavioral Health Agency · La Fayette, GA

NPI 1801433974 · NPPES record last updated Dec 7, 2019

Key facts

NPI
1801433974
Entity type
Individual (NPI type 1)
Primary specialty
Community/Behavioral Health Agency 251S00000X
Practice address
894 Kemp Rd
La Fayette, GA 30728-5016
Phone
(423) 991-0034
NPI assigned
Dec 7, 2019
Sex
Female
Sole proprietor
Yes

Organizations & group practices 1

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.

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

Practice roles

OrganizationSpecialtyStatusNew patients
Lookout Mountain Community Services Community/Behavioral Health Current
since Dec 28, 2022
Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Behavioral Health Agency 251S00000X GA Yes

Addresses

Primary practice location

894 Kemp Rd
La Fayette, GA 30728-5016

Mailing address

501 Mize St
La Fayette, GA 30728-3346
Phone (423) 991-0034

Other providers in La Fayette, GA

All providers in La Fayette, GA · Community/Behavioral Health Agency in Georgia

Sources for this page

Verify at the official NPI Registry.