Provider Demographics
NPI:1821619628
Name:EAMES, JESICA M (LCSW/JD)
Entity Type:Individual
Prefix:
First Name:JESICA
Middle Name:M
Last Name:EAMES
Suffix:
Gender:F
Credentials:LCSW/JD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:956 EUCLID AVE NE
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30307-2532
Mailing Address - Country:US
Mailing Address - Phone:404-584-7500
Mailing Address - Fax:
Practice Address - Street 1:956 EUCLID AVE NE
Practice Address - Street 2:
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30307-2532
Practice Address - Country:US
Practice Address - Phone:404-584-7500
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-05-03
Last Update Date:2020-05-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAMSW0065701041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical