Provider Demographics
NPI:1508360140
Name:JAI DAMES LLC
Entity Type:Organization
Organization Name:JAI DAMES LLC
Other - Org Name:JAI DAMES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JAI
Authorized Official - Middle Name:
Authorized Official - Last Name:DAMES
Authorized Official - Suffix:
Authorized Official - Credentials:LMFT
Authorized Official - Phone:404-975-4155
Mailing Address - Street 1:4575 WEBB BRIDGE RD STE 4911
Mailing Address - Street 2:
Mailing Address - City:ALPHARETTA
Mailing Address - State:GA
Mailing Address - Zip Code:30005-4256
Mailing Address - Country:US
Mailing Address - Phone:404-975-4155
Mailing Address - Fax:404-975-4156
Practice Address - Street 1:2398 MOUNT VERNON RD STE 150
Practice Address - Street 2:
Practice Address - City:DUNWOODY
Practice Address - State:GA
Practice Address - Zip Code:30338-3064
Practice Address - Country:US
Practice Address - Phone:404-975-4155
Practice Address - Fax:404-975-4156
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-03-20
Last Update Date:2018-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAAPC005374101YM0800X
GAMFT001578106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Multi-Specialty
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty