Provider Demographics
NPI:1669042552
Name:DENNARD, TA'MERIA (LMSW)
Entity type:Individual
Prefix:
First Name:TA'MERIA
Middle Name:
Last Name:DENNARD
Suffix:
Gender:
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5750 BUFFINGTON RD UNIT 10306
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30349-7440
Mailing Address - Country:US
Mailing Address - Phone:229-344-6989
Mailing Address - Fax:
Practice Address - Street 1:5750 BUFFINGTON RD UNIT 10306
Practice Address - Street 2:
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30349-7440
Practice Address - Country:US
Practice Address - Phone:229-344-6989
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-07-01
Last Update Date:2025-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
106S00000X
GAMSW012274104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker
No106S00000XBehavioral Health & Social Service ProvidersBehavior Technician