Healthcare Provider Details

I. General information

NPI: 1962333195
Provider Name (Legal Business Name): CHRISTIE TENNEY CASE MANAGER
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/27/2026
Last Update Date: 05/27/2026
Certification Date: 05/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

55 JEFFERSON PKWY STE 55B
NEWNAN GA
30263-5813
US

IV. Provider business mailing address

55 JEFFERSON PKWY STE 55
NEWNAN GA
30263-5813
US

V. Phone/Fax

Practice location:
  • Phone: 770-683-6946
  • Fax:
Mailing address:
  • Phone: 770-683-6946
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: