Basic Information
| Provider Information | |||||||||
| NPI: | 1730750084 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | WEEKS | ||||||||
| FirstName: | DARREN | ||||||||
| MiddleName: | GERALD | ||||||||
| NamePrefix: | MR. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1289 GI MADDOX PKWY | ||||||||
| Address2: | |||||||||
| City: | CHATSWORTH | ||||||||
| State: | GA | ||||||||
| PostalCode: | 307052069 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7069713366 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 1289 GI MADDOX PKWY | ||||||||
| Address2: | |||||||||
| City: | CHATSWORTH | ||||||||
| State: | GA | ||||||||
| PostalCode: | 307052069 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7069713366 | ||||||||
| FaxNumber: | 7064260949 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/08/2021 | ||||||||
| LastUpdateDate: | 07/08/2021 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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| NPICertificationDate: | 07/08/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 101YA0400X | GA | Y | Behavioral Health & Social Service Providers | Counselor | Addiction (Substance Use Disorder) |
No ID Information.