Provider Demographics
NPI:1649904384
Name:DEMPS, KASHEENA (LMSW)
Entity type:Individual
Prefix:
First Name:KASHEENA
Middle Name:
Last Name:DEMPS
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3911 MARY ELIZA TRCE NW STE 200
Mailing Address - Street 2:
Mailing Address - City:MARIETTA
Mailing Address - State:GA
Mailing Address - Zip Code:30064-1088
Mailing Address - Country:US
Mailing Address - Phone:470-792-7374
Mailing Address - Fax:
Practice Address - Street 1:3911 MARY ELIZA TRCE NW STE 200
Practice Address - Street 2:
Practice Address - City:MARIETTA
Practice Address - State:GA
Practice Address - Zip Code:30064-1088
Practice Address - Country:US
Practice Address - Phone:678-631-9907
Practice Address - Fax:678-701-7909
Is Sole Proprietor?:Yes
Enumeration Date:2022-07-09
Last Update Date:2022-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAMSW010244104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker