Provider Demographics
NPI:1609333756
Name:LLOYD, DEANDRE (LMSW)
Entity Type:Individual
Prefix:
First Name:DEANDRE
Middle Name:
Last Name:LLOYD
Suffix:
Gender:M
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:199 FRASIER ST SE
Mailing Address - Street 2:
Mailing Address - City:MARIETTA
Mailing Address - State:GA
Mailing Address - Zip Code:30060-2201
Mailing Address - Country:US
Mailing Address - Phone:770-954-8593
Mailing Address - Fax:
Practice Address - Street 1:199 FRASIER ST SE
Practice Address - Street 2:
Practice Address - City:MARIETTA
Practice Address - State:GA
Practice Address - Zip Code:30060-2201
Practice Address - Country:US
Practice Address - Phone:770-954-8593
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-02-25
Last Update Date:2019-02-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAMSW0087211041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical