Individual provider Active NPI

Mary Leigh Denton Sr., L.C.S.W.

  • Clinical Social Worker
  • Canton, GA
National Provider Identifier
1861530453
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
1235 Issued in GA
Practice address
2920 Marietta Hwy Ste 8
Canton, GA 30114-8212
Phone
(770) 345-7149
Fax
(770) 345-1277
NPI assigned
Feb 3, 2007
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 1235 GA Primary

Addresses

Primary practice location

2920 Marietta Hwy Ste 8
Canton, GA 30114-8212

Mailing address

PO Box 1545
Canton, GA 30169-1545
Phone (770) 345-7149

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110208000611 GA Practitioner - Clinical Social Worker 5698955664 Practice locations: Canton, GA; Jasper, GA

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1986
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

505 Cove Rd
Jasper, GA 30143-1363
Phone (770) 345-7149

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1235GAMDAddiction (Substance Use Disorder) Counselor

NPI Registry JSON

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

{
    "created_epoch": "1170460800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1861530453",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1545",
            "city": "CANTON",
            "state": "GA",
            "postal_code": "301691545",
            "telephone_number": "770-345-7149",
            "fax_number": "770-345-1277"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2920 MARIETTA HWY STE 8",
            "city": "CANTON",
            "state": "GA",
            "postal_code": "301148212",
            "telephone_number": "770-345-7149",
            "fax_number": "770-345-1277"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DENTON",
        "first_name": "MARY",
        "middle_name": "LEIGH",
        "name_prefix": "Ms.",
        "name_suffix": "Sr.",
        "credential": "L.C.S.W.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-02-03",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "GA",
            "license": "1235",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Canton, GA

Sources for this page

Verify at the official NPI Registry.