Provider Demographics
NPI:1255949053
Name:LESTER, JAMIE MARIE (MSW)
Entity type:Individual
Prefix:
First Name:JAMIE
Middle Name:MARIE
Last Name:LESTER
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:JAMIE
Other - Middle Name:MARIE
Other - Last Name:HERKEL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:6080 LAKEVIEW RD APT 1408
Mailing Address - Street 2:
Mailing Address - City:WARNER ROBINS
Mailing Address - State:GA
Mailing Address - Zip Code:31088-9108
Mailing Address - Country:US
Mailing Address - Phone:570-768-1572
Mailing Address - Fax:
Practice Address - Street 1:607 RUSSELL PKWY STE A
Practice Address - Street 2:
Practice Address - City:WARNER ROBINS
Practice Address - State:GA
Practice Address - Zip Code:31088-7690
Practice Address - Country:US
Practice Address - Phone:478-225-9860
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-07-17
Last Update Date:2020-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)Group - Multi-Specialty