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Kaneisha Mack, CPS-WH
Peer Specialist in Lagrange, Georgia
NPI 1952862286

Kaneisha Mack is a Peer Specialist based in Lagrange, GA. Kaneisha Mack practices in Lagrange, GA and has the professional credentials of CPS-WH. The NPI Number for Kaneisha Mack is 1952862286 and holds a License No. (Georgia).

The current practice location address for Kaneisha Mack is 122 Gordon Commercial Dr, Lagrange, GA and can be reached out via phone at 706-845-4054.

Location: 122 Gordon Commercial Dr, Lagrange, GA, 30240-5754
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1952862286
Provider Name
Kaneisha Mack
Credential
CPS-WH
Provider Entity Type
Individual
Gender
Female
Address
122 Gordon Commercial Dr, Lagrange, GA, 30240-5754
Phone Number
706-845-4054
Fax Number
Provider Enumeration Date
03/28/2019
Last Update Date
03/10/2024
institution
Provider Business Practice Location Address Details
Address
122 Gordon Commercial Dr
City
Lagrange
State
Georgia
Zip
30240-5754
Phone Number
706-845-4054
Fax Number
person
Provider Business Mailing Address Details
Address
122 Gordon Commercial Dr
City
Lagrange
State
Georgia
Zip
30240-5754
Phone Number
706-845-4054
Fax Number
person
Provider's Taxonomy Details 1
Type
Other Service Providers
Classification
Peer Specialist
Speciality
-
Taxonomy
175T00000X
License No.
()
Definition
Individuals certified to perform peer support services through a training process defined by a government agency, such as the Department of Veterans Affairs or a state mental health department/certification/licensing authority.
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