Provider Demographics
NPI:1720133523
Name:DENNY, KENNETH MAURICE (LCSW)
Entity Type:Individual
Prefix:MR
First Name:KENNETH
Middle Name:MAURICE
Last Name:DENNY
Suffix:
Gender:M
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:22 W BRYAN ST # 134
Mailing Address - Street 2:
Mailing Address - City:SAVANNAH
Mailing Address - State:GA
Mailing Address - Zip Code:31401-2604
Mailing Address - Country:US
Mailing Address - Phone:912-231-9403
Mailing Address - Fax:912-238-0238
Practice Address - Street 1:7 DRAYTON ST
Practice Address - Street 2:SUITE 308
Practice Address - City:SAVANNAH
Practice Address - State:GA
Practice Address - Zip Code:31401-2723
Practice Address - Country:US
Practice Address - Phone:912-231-9403
Practice Address - Fax:912-238-0238
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-24
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA0016541041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
GAR13042Medicare UPIN