Provider Demographics
NPI:1285147231
Name:ELLIOTT, JADA MCNAIR (LMSW)
Entity type:Individual
Prefix:MRS
First Name:JADA
Middle Name:MCNAIR
Last Name:ELLIOTT
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:195 SUN VALLEY DR
Mailing Address - Street 2:
Mailing Address - City:MACON
Mailing Address - State:GA
Mailing Address - Zip Code:31211-7415
Mailing Address - Country:US
Mailing Address - Phone:478-957-4482
Mailing Address - Fax:
Practice Address - Street 1:761 POPLAR ST STE 1K
Practice Address - Street 2:
Practice Address - City:MACON
Practice Address - State:GA
Practice Address - Zip Code:31201-2061
Practice Address - Country:US
Practice Address - Phone:478-957-4482
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-11-13
Last Update Date:2023-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker