Healthcare Provider Details

I. General information

NPI: 1972146488
Provider Name (Legal Business Name): JESHONDA DENNIS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/28/2019
Last Update Date: 02/27/2025
Certification Date: 02/27/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

256 CHAPMAN RD STE 201
NEWARK DE
19702-5415
US

IV. Provider business mailing address

2030 GENERALS WAY APT B202
DOVER DE
19901-5380
US

V. Phone/Fax

Practice location:
  • Phone: 302-292-1334
  • Fax:
Mailing address:
  • Phone: 302-310-2811
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberQ1-0012423
License Number StateDE
# 2
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number31994
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: