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NPI Code Detail

MEDICARE: SHAMIKA C DENT MBA

MEDICARE:   SHAMIKA C DENT  MBA
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
1101YA0400XAddiction (Substance Use Disorder) Counselor
2101YM0800XMental Health Counselor
3103K00000XBehavior Analyst
4103TB0200XCognitive & Behavioral Psychologist
5104100000XSocial Worker
61041C0700XClinical Social Worker
7106H00000XMarriage & Family Therapist

General Provider Information

NPI Number : 1992105720
Entity Type Code : Individual
Provider Name (Legal Business Name) : SHAMIKA C DENT MBA
Provider Business Mailing Address
First Line : PO BOX 150785
Second Line :
City : ATLANTA
State : GA
Zip : 30315-0193
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 3355 LENOX RD NE STE 750
Second Line :
City : ATLANTA
State : GA
Zip : 30326-1353
Country : US
Telephone Number : 404-761-4070
Fax Number : 404-761-4070
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/29/2014
Last Update Date : 08/29/2014

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Directions to “ SHAMIKA C DENT MBA” Practice Location

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