Provider Demographics
NPI:1154213049
Name:DEAN, LAKESHA JACKSON
Entity type:Individual
Prefix:DR
First Name:LAKESHA
Middle Name:JACKSON
Last Name:DEAN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:152 GREYSTONE DR
Mailing Address - Street 2:
Mailing Address - City:GUYTON
Mailing Address - State:GA
Mailing Address - Zip Code:31312-5539
Mailing Address - Country:US
Mailing Address - Phone:912-410-8990
Mailing Address - Fax:912-410-8990
Practice Address - Street 1:152 GREYSTONE DR
Practice Address - Street 2:
Practice Address - City:GUYTON
Practice Address - State:GA
Practice Address - Zip Code:31312-5539
Practice Address - Country:US
Practice Address - Phone:912-410-8990
Practice Address - Fax:912-410-8990
Is Sole Proprietor?:No
Enumeration Date:2025-07-16
Last Update Date:2025-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101Y00000XBehavioral Health & Social Service ProvidersCounselor
No101YP1600XBehavioral Health & Social Service ProvidersCounselorPastoral
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No171400000XOther Service ProvidersHealth & Wellness Coach