Healthcare Provider Details

I. General information

NPI: 1891314175
Provider Name (Legal Business Name): JENNIFER DAY LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: JENNIDER HARPER LMSW

II. Dates (important events)

Enumeration Date: 04/16/2020
Last Update Date: 05/03/2024
Certification Date: 05/03/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4006 HIGHWAY 34 E
SHARPSBURG GA
30277-3531
US

IV. Provider business mailing address

122 GORDON COMMERCIAL DR
LAGRANGE GA
30240-5754
US

V. Phone/Fax

Practice location:
  • Phone: 404-960-1282
  • Fax: 855-817-2428
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code104100000X
TaxonomySocial Worker
License NumberMSW008352
License Number StateGA
# 2
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberCSW009016
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: