Provider Demographics
NPI:1144687526
Name:JAMES, ENNISIA TEKEISHA (LCSW)
Entity type:Individual
Prefix:
First Name:ENNISIA
Middle Name:TEKEISHA
Last Name:JAMES
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:ENNISIA
Other - Middle Name:
Other - Last Name:HENDERSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1700 NORTHSIDE DRIVE NW
Mailing Address - Street 2:SUITE A7 UNIT# 5188
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30318
Mailing Address - Country:US
Mailing Address - Phone:404-694-5469
Mailing Address - Fax:
Practice Address - Street 1:121 EAGLES CREST LN
Practice Address - Street 2:
Practice Address - City:MCDONOUGH
Practice Address - State:GA
Practice Address - Zip Code:30253-4265
Practice Address - Country:US
Practice Address - Phone:404-694-5469
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-01-15
Last Update Date:2025-04-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
No171M00000XOther Service ProvidersCase Manager/Care Coordinator