MEDICARE: MARQUITA LATAVOUS GARNES LCSW

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1041C0700X	Clinical Social Worker	CSW009377	GA

General Provider Information

NPI Number	:	1609685411
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MARQUITA LATAVOUS GARNES LCSW

Provider Business Mailing Address
First Line	:	1003 CLAXTON DAIRY RD APT 500C
Second Line	:
City	:	DUBLIN
State	:	GA
Zip	:	31021-5578
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	PO BOX 85
Second Line	:
City	:	LUMBER CITY
State	:	GA
Zip	:	31549-0085
Country	:	US
Telephone Number	:	478-353-3339
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/06/2025
Last Update Date	:	03/13/2026

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