=====================================================
General NPI Number Information
=====================================================
NPI Number | 1093517088
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | MACI LENORA HARMON LMSW
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 03/27/2025
-----------------------------------------------------
Last Update Date | 03/27/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 206 E LAMAR ST
-----------------------------------------------------
City | AMERICUS
-----------------------------------------------------
State | GA
-----------------------------------------------------
Zip | 31709-3657
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 229-928-0581
-----------------------------------------------------
Fax | 229-928-0875
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 206 E LAMAR ST
-----------------------------------------------------
City | AMERICUS
-----------------------------------------------------
State | GA
-----------------------------------------------------
Zip | 31709-3657
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 229-928-0581
-----------------------------------------------------
Fax | 229-928-0875
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 104100000X
-----------------------------------------------------
Taxonomy Name | Social Worker
-----------------------------------------------------
License Number | MSW012183
-----------------------------------------------------
License Number State | GA
-----------------------------------------------------