Provider Demographics
NPI:1073053047
Name:PINCKNEY, DENA KRISTEN (LCSW)
Entity Type:Individual
Prefix:
First Name:DENA
Middle Name:KRISTEN
Last Name:PINCKNEY
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4784 SILVER LAKE DR
Mailing Address - Street 2:
Mailing Address - City:EVANS
Mailing Address - State:GA
Mailing Address - Zip Code:30809-5404
Mailing Address - Country:US
Mailing Address - Phone:706-751-9107
Mailing Address - Fax:888-345-7089
Practice Address - Street 1:601 N BELAIR SQ STE 2
Practice Address - Street 2:
Practice Address - City:EVANS
Practice Address - State:GA
Practice Address - Zip Code:30809-4322
Practice Address - Country:US
Practice Address - Phone:706-751-9107
Practice Address - Fax:888-345-7089
Is Sole Proprietor?:Yes
Enumeration Date:2017-02-24
Last Update Date:2018-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GACSW0057111041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical