Healthcare Provider Details

I. General information

NPI: 1598686065
Provider Name (Legal Business Name): DESTINEY DEMPSEY LMSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/22/2026
Last Update Date: 07/22/2026
Certification Date: 07/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

333 ALCOVY ST STE 5
MONROE GA
30655-2180
US

IV. Provider business mailing address

847 MAULDIN RD
JEFFERSON GA
30549-1320
US

V. Phone/Fax

Practice location:
  • Phone: 770-599-7508
  • Fax: 866-734-7631
Mailing address:
  • Phone: 706-351-1275
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberMSW013287
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: