LESLIE JEAN QUACKENBUSH (NPI# 1093005795) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1093005795 |
| Entity Type | Individual |
| Full Name | LESLIE JEAN QUACKENBUSH |
| Credential | LCSW |
| Practice Address |
3650 Steve Reynolds Blvd Gwinnett Comprehensive Medical Center Duluth GA 30096 |
| Mailing Address |
3495 Piedmont Road, Ne Nine Piedmont Center Atlanta GA 30305 |
| Practice Telephone | 9197642000 |
| Mailing Telephone | 4045045678 |
| Enumeration Date | 2011-04-14 |
| Last Update Date | 2016-11-14 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1041C0700X |
Social Worker Specialization: Clinical |
CSW005307 | GA | Behavioral Health & Social Service Providers |
| N | 1041C0700X |
Social Worker Specialization: Clinical |
P004774 | NC | Behavioral Health & Social Service Providers |
| Street Address |
3650 STEVE REYNOLDS BLVD GWINNETT COMPREHENSIVE MEDICAL CENTER |
| City | DULUTH |
| State | GA |
| Zip Code | 30096 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1831194893 | Barbara Joan Kell | Nurse Practitioner | 3650 Steve Reynolds Blvd, Duluth, GA 30096-4506 | 2005-06-16 |
| 1750906715 | Grace Elizabeth Mason | Nurse Practitioner | 3650 Steve Reynolds Blvd, Duluth, GA 30096-4506 | 2020-06-15 |
| 1881181584 | Cynthia Denise Humenic | Nurse Practitioner | 3650 Steve Reynolds Blvd, Duluth, GA 30096-4506 | 2018-04-18 |
| 1194230540 | Jenna Dannenbaum | Nurse Practitioner | 3650 Steve Reynolds Blvd, Duluth, GA 30096-4506 | 2017-12-07 |
| 1568994135 | Yolanda Gray-rozier | Registered Nurse | 3650 Steve Reynolds Blvd, Duluth, GA 30096-4506 | 2017-04-01 |
| 1306394655 | Carlie Lynne Adams | Dietitian, Registered | 3650 Steve Reynolds Blvd, Duluth, GA 30096-4506 | 2016-09-15 |
| 1114379757 | Miriam Abouelnasr Gomes | Physician Assistant | 3650 Steve Reynolds Blvd, Duluth, GA 30096-4506 | 2016-07-07 |
| 1699158584 | Ann Whitaker | Dietitian, Registered | 3650 Steve Reynolds Blvd, Duluth, GA 30096-4506 | 2015-07-09 |
| 1548643968 | Paula Gilman | Dietitian, Registered | 3650 Steve Reynolds Blvd, Duluth, GA 30096-4506 | 2015-07-02 |
| 1750763173 | Emily Kim | Internal Medicine | 3650 Steve Reynolds Blvd, Duluth, GA 30096-4506 | 2015-06-22 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1922615897 | Georgia Eye Optical, LLC | Ophthalmology | 3800 Pleasant Hill Rd Ste 3, Duluth, GA 30096 | 2020-09-25 |
| 1568090868 | Positive Behavior Services, Inc | Behavior Technician | 3765 Crestwood Pkwy Nw, Duluth, GA 30096 | 2020-03-31 |
| 1861031940 | Elizabeth Ashley Edouard | Counselor | 3464 Duluth Hwy 120, Duluth, GA 30096 | 2020-01-06 |
| 1245701044 | Kathryn Irene Vaughn | Social Worker | 3968 Mainsail Court, Duluth, GA 30096 | 2018-12-06 |
| 1083184626 | Aica Orthopedics, P.C. | Orthopaedic Surgery | 3775 Venture Drive Bldg F, Duluth, GA 30096 | 2018-11-27 |
| 1245709799 | Positive Impact Health Centers, Inc. | Pharmacy | 3350 Breckinridge Blvd, Suite 200a, Duluth, GA 30096 | 2018-11-14 |
| 1235611724 | Katherine Winstead Knott | Counselor | 3460 Summit Ridge Parkway, Suite 503, Duluth, GA 30096 | 2018-08-31 |
| 1710467857 | Envision Optics LLC | Optometrist | 1943 Pleasant Hill Rd, Duluth, GA 30096 | 2018-08-17 |
| 1104314202 | Erin Mckernan Scupham | Chiropractor | 3820 Pleasant Hill Rd. Ne, Suite 4, Duluth, GA 30096 | 2018-04-25 |
| 1053839456 | Rogers Bridge Pediatric Therapy, LLC | Clinic/Center | 2845 Summercrest Ln, Duluth, GA 30096 | 2017-09-06 |
| Find all providers in zip 30096 | ||||
| Taxonomy Code | 1041C0700X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Social Worker |
| Specialization | Clinical |
| A social worker who holds a master’s or doctoral degree in social work from an accredited school of social work in addition to at least two years of post-master’s supervised experience in a clinical setting. The social worker must be licensed, certified, or registered at the clinical level in the jurisdiction of practice. A clinical social worker provides direct services, including interventions focused on interpersonal interactions, intrapsychic dynamics, and life management issues. Clinical social work services are based on bio-psychosocial perspectives. Services consist of assessment, diagnosis, treatment (including psychotherapy and counseling), client-centered advocacy, consultation, evaluation, and prevention of mental illness, emotional, or behavioral disturbances. |
| Notes: Source: National Association of Social Workers, 2008 [7/1/2009: definition modified] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1497366611 | Harvest Moon Mental Health Services, LLC | Social Worker | 1509 E Superior St Apt 203, Duluth, MN 55812-4402 | 2020-08-11 |
| 1235756784 | Allissa Rardin | Social Worker | 720 N Central Ave, Duluth, MN 55807-1305 | 2020-07-01 |
| 1245701044 | Kathryn Irene Vaughn | Social Worker | 3968 Mainsail Court, Duluth, GA 30096 | 2018-12-06 |
| 1063915239 | Jpw Counseling & Consultation | Social Worker | 302 W Superior St Ste 508, Duluth, MN 55802 | 2018-03-14 |
| 1205348372 | Viloria C Jackson | Social Worker | 3611 Gray Pl, Duluth, GA 30096-3298 | 2017-10-30 |
| 1992225668 | Splady Therapy Services, LLC | Social Worker | 205 W 2nd St Ste 421, Duluth, MN 55802-1920 | 2017-06-23 |
| 1568999308 | Jim Gaylord | Social Worker | 6208 E Superior St, Duluth, MN 55804-2542 | 2017-05-11 |
| 1962860940 | Devon Maycock | Social Worker | 1027 N 8th Ave E, Duluth, MN 55805-1427 | 2016-02-04 |
| 1457718744 | Matheny Therapy & Consulting, LLC | Social Worker | 5241 N Shore Dr, Duluth, MN 55804-2911 | 2016-01-18 |
| 1689044620 | Mari Trine | Social Worker | 2421 London Rd, Duluth, MN 55812-2222 | 2015-10-02 |
| Find all providers in DULUTH | ||||
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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.