DR. CHRISTINE JO JENNINGS (NPI# 1285969089) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1285969089 |
| Entity Type | Individual |
| Full Name | DR. CHRISTINE JO JENNINGS |
| Credential | PSY.D. |
| Practice Address |
406 N Main St La Fayette GA 30728-2424 |
| Mailing Address |
Po Box 1085 La Fayette GA 30728-1085 |
| Practice Telephone | 7066382339 |
| Practice Fax Number | 7066387400 |
| Mailing Telephone | 7066382339 |
| Mailing Fax Number | 7066387400 |
| Enumeration Date | 2009-10-12 |
| Last Update Date | 2009-10-12 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 103TC2200X |
Psychologist Specialization: Clinical Child & Adolescent |
001559 | GA | Behavioral Health & Social Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| GA | 00484811C | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1942721071 | Christine Rose Jennings | Registered Nurse | 911 N 10th Pl, Renton, WA 98057-0009 | 2017-06-28 |
| 1285838979 | Christine Ann Jennings | Midwife | 1100 Johnson Ferry Rd Ne, Suite 800, Atlanta, GA 30342-1709 | 2007-06-14 |
| Street Address |
406 N MAIN ST |
| City | LA FAYETTE |
| State | GA |
| Zip Code | 30728-2424 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1205919891 | Northwest Georgia Psychological Services | Psychologist | 406 N Main St, La Fayette, GA 30728-2424 | 2006-10-24 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1891395620 | Primary Health Care Center of Dade, Inc. | Clinic/Center | 8a Probasco Street Unit 214, Lafayette, GA 30728 | 2020-10-30 |
| 1891358750 | K -va -t Food Stores Inc | Durable Medical Equipment & Medical Supplies | 311 North Main Street, Lafayette, GA 30728 | 2019-04-17 |
| 1023505914 | Heather Staton | Pharmacist | 324 W. Patton Street, Lafayette, GA 30728 | 2018-04-17 |
| 1023484805 | Tyler Kellum Levie | Dentist | 201 E. Villanow Street, Lafayette, GA 30728 | 2015-08-17 |
| 1083987481 | Krishawna Elaine Montgomery | Counselor | 501 Mize Street Lookout Mountain Community Services, Lafayette, GA 30728 | 2012-02-15 |
| 1346518198 | William Randall Smith | Behavioral Analyst | 902 Daugherty Street, Lafayette, GA 30728 | 2011-12-08 |
| 1821321506 | John H Rockwell | Contractor | 143 Golden Oaks Dr, La Fayette, GA 30728 | 2009-09-11 |
| 1619113057 | Lookout Mountain Community Services | Community/Behavioral Health | 43 Shady Court, Lafayette, GA 30728 | 2009-01-06 |
| 1326212705 | Lookout Mountain Community Services | Community/Behavioral Health | 1218 Chattanooga St., Lafayette, GA 30728 | 2008-04-17 |
| 1649444084 | Lookout Mountain Community Services | Community/Behavioral Health | 29 Mae Tucker Rd., Lafayette, GA 30728 | 2008-04-16 |
| Find all providers in zip 30728 | ||||
| Taxonomy Code | 103TC2200X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Psychologist |
| Specialization | Clinical Child & Adolescent |
| Definition to come... |
| Notes: [1/1/2007: title modified] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1538693254 | Rachel Yosick | Psychologist | 520 Wembley Cir, Sandy Springs, GA 30328-6753 | 2017-04-19 |
| 1174974620 | Warren Umansky, Ph.d. | Psychologist | 302 Wheeler Executive Ctr, Augusta, GA 30909 | 2016-06-27 |
| 1245655893 | Tiffany Gilmore Randell | Psychologist | 101 Devant Street, Office 401, Fayetteville, GA 30214 | 2014-02-19 |
| 1972927861 | Tyrone D. Lane Enterprises, Incorporated | Psychologist | 5304 Panola Industrial Boulevard, Suite L, Decatur, GA 30035 | 2014-02-12 |
| 1720409493 | Tonya Favors | Psychologist | 311 S Lee St, Apt C, Americus, GA 31709-3971 | 2013-12-26 |
| 1912336546 | Francine Adams | Psychologist | 324 Trace Ln, Lawrenceville, GA 30046-2896 | 2013-11-04 |
| 1447542691 | Erin Marie Jones | Psychologist | 1256 Briarcliff Rd Ne Ste 322e, Atlanta, GA 30306-2636 | 2011-05-06 |
| 1164729901 | Tiffany Whitworth | Psychologist | 4139 Hospital Dr Ne, Covington, GA 30014-2565 | 2011-02-14 |
| 1548573264 | Kimberley Blaker Saye | Psychologist | 4695 Mahonia Way Nw, Acworth, GA 30102-3575 | 2010-07-22 |
| 1316269350 | Caitlin Herzinger Delfs | Psychologist | 4994 Lower Roswell Rd Ste 10, Marietta, GA 30068-4332 | 2010-02-18 |
| Find all providers with the same taxonomy | ||||
| City | LA FAYETTE |
| Zip Code | 30728 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.