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NPI Code Detail

MEDICARE: AUDRETTA JAMISON LCSW

MEDICARE:   AUDRETTA  JAMISON  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
11041C0700XClinical Social WorkerCSW010336GA

General Provider Information

NPI Number : 1699607846
Entity Type Code : Individual
Provider Name (Legal Business Name) : AUDRETTA JAMISON LCSW
Provider Business Mailing Address
First Line : 560 SEDONA LOOP
Second Line :
City : HAMPTON
State : GA
Zip : 30228-2554
Country : US
Telephone Number : 470-615-0111
Fax Number :
Provider Business Practice Location Address
First Line : 560 SEDONA LOOP
Second Line :
City : HAMPTON
State : GA
Zip : 30228-2554
Country : US
Telephone Number : 470-615-0111
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/02/2026
Last Update Date : 06/02/2026

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Directions to “ AUDRETTA JAMISON LCSW” Practice Location

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