Provider Demographics
NPI:1457500365
Name:MINCEY, JEADEIA
Entity Type:Individual
Prefix:
First Name:JEADEIA
Middle Name:
Last Name:MINCEY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:138 S ROBINHOOD DR
Mailing Address - Street 2:
Mailing Address - City:SAVANNAH
Mailing Address - State:GA
Mailing Address - Zip Code:31406-4151
Mailing Address - Country:US
Mailing Address - Phone:912-507-2120
Mailing Address - Fax:
Practice Address - Street 1:42 & 44 MEDICAL ARTS CENTER
Practice Address - Street 2:
Practice Address - City:SAVANNAH
Practice Address - State:GA
Practice Address - Zip Code:31401
Practice Address - Country:US
Practice Address - Phone:912-354-5780
Practice Address - Fax:912-354-5781
Is Sole Proprietor?:No
Enumeration Date:2008-09-16
Last Update Date:2008-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker