DR KENNEITH DURDEN OUTREACH (NPI# 1699120410) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1699120410 |
| Entity Type | Organization |
| Organization Name | DR KENNEITH DURDEN OUTREACH |
| Practice Address |
41 Moonlight Trl Port Wentworth GA 31407-3321 |
| Practice Telephone | 4049092442 |
| Mailing Telephone | 4049092442 |
| Enumeration Date | 2016-04-29 |
| Last Update Date | 2016-04-29 |
| Authorized Official Name | KENNEITH DURDEN (CEO) |
| Authorized Official Telephone | 4049092442 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 101YP2500X |
Counselor Specialization: Professional |
Behavioral Health & Social Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| GA | 803411511B | 05 |
| Street Address |
41 MOONLIGHT TRL |
| City | PORT WENTWORTH |
| State | GA |
| Zip Code | 31407-3321 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1295969228 | Kurt Singh Kang | Internal Medicine | 101 W Mulberry Blvd Ste 100, Savannah, GA 31407 | 2009-05-05 |
| 1144829102 | Estefania Salinas | Counselor | 1565 Benton Blvd Apt 412, Savannah, GA 31407-0408 | 2020-10-21 |
| 1861038044 | Mara Dawne Carson | Nurse Practitioner | 1515 Benton Blvd Apt 1328, Savannah, GA 31407-0440 | 2019-11-21 |
| 1831620087 | Pharmdixon Consulting LLC | Pharmacy | 2155 Benton Blvd, 13203, Savannah, GA 31407-0491 | 2017-03-21 |
| 1033610415 | Derrick Jackson Thomas | Specialist/Technologist | 1 Bonnybridge Rd, Savannah, GA 31407-1312 | 2018-02-22 |
| 1043209240 | Westview Nursing and Rehabilitation Center, LLC | Skilled Nursing Facility | 1000 Dorset Rd, Port Wentworth, GA 31407-1517 | 2005-10-19 |
| 1922575679 | Pruitthealth - Seaside, LLC | Skilled Nursing Facility | 1000 Dorset Rd, Port Wentworth, GA 31407-1517 | 2018-10-31 |
| 1477060705 | Benjamin Lane Richey | Behavior Technician | 204 Turnberry St, Port Wentworth, GA 31407-1925 | 2018-01-09 |
| 1538772363 | Marian Marshall | Social Worker | 117 Whitehavven Rd, Savannah, GA 31407-3140 | 2020-08-31 |
| 1508405952 | Shannon Williams | Technician/Technologist | 34 Birch Cir, Port Wentworth, GA 31407-3376 | 2020-01-02 |
| Find all providers in zip 31407 | ||||
| Taxonomy Code | 101YP2500X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Counselor |
| Specialization | Professional |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1184895930 | Kenneith Durden | Counselor | 7306 Ga Highway 21, Ste 101-225, Port Wentworth, GA 31407-9274 | 2008-03-20 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1265033070 | Joseph Barber | Counselor | 114 Hope Dr, Dallas, GA 30157-2569 | 2020-11-06 |
| 1114528957 | Takelia Hughey | Counselor | 2875 Spring Villa Ln Se, Smyrna, GA 30080-3644 | 2020-11-06 |
| 1083215685 | Peace of Mind Counseling and Therapeutic Services | Counselor | 290 Baywood Way, Hiram, GA 30141-3186 | 2020-11-02 |
| 1780284513 | Hogue Counseling and Consulting Services, LLC | Counselor | 7861 Waterlace Dr, Fairburn, GA 30213-4648 | 2020-10-30 |
| 1245830140 | Tiffany Alberto | Counselor | 350 Lyndale Dr Se, Atlanta, GA 30316-2692 | 2020-10-29 |
| 1013517465 | Tequila Olivia Banks | Counselor | 8303 Dunleaf Arc Way Nw, Norcross, GA 30093 | 2020-10-27 |
| 1598365033 | Tiffany Johnson | Counselor | 309 Ivy Chase Ln, Peachtree Corners, GA 30092-4641 | 2020-10-26 |
| 1568061331 | Justin White | Counselor | 1025 Powers Pl, Alpharetta, GA 30009-8356 | 2020-10-22 |
| 1295334209 | Mark Alan Beach | Counselor | 320 Victory Home Ln, Clarkesville, GA 30523 | 2020-10-21 |
| 1396344339 | Savannah Therapeutic Services, LLC | Counselor | 2431 Habersham St Ste C, Savannah, GA 31401-9360 | 2020-10-21 |
| Find all providers with the same taxonomy | ||||
| City | PORT WENTWORTH |
| Zip Code | 31407 |
Please comment or provide details below to improve the information on DR KENNEITH DURDEN OUTREACH.
| 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.