Isom Eugene White, LCSW | |
1 Huntington Rd Ste 703, Athens, GA 30606-7214 | |
(706) 425-8900 | |
Not Available |
Full Name | Isom Eugene White |
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Gender | Male |
Speciality | Social Worker - Clinical |
Location | 1 Huntington Rd Ste 703, Athens, Georgia |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1265916464 | NPI | - | NPPES |
CSW006575 | Other | GA | STATE OF GEORGIA |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
1041C0700X | Social Worker - Clinical | CSW0006575 (Georgia) | Primary |
Entity Name | Isom E White Lcsw, Llc |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1104300250 PECOS PAC ID: 5294072252 Enrollment ID: O20190129001638 |
Mailing Address | Practice Location Address |
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Isom Eugene White, LCSW Po Box 813654, Smyrna, GA 30081-8654 Ph: (706) 425-8900 | Isom Eugene White, LCSW 1 Huntington Rd Ste 703, Athens, GA 30606-7214 Ph: (706) 425-8900 |
Lori Whitmire, LCSW Clinical Social Worker Medicare: Medicare Enrolled Practice Location: 1435 Oglethorpe Ave, Athens, GA 30606 Phone: 706-549-7755 Fax: 706-549-0428 | |
Dr. Omar Tremayne Sims, PHD, LCSW Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 455 N Lumpkin St, Athens, GA 30601 Phone: 706-369-7911 Fax: 706-208-9509 | |
Matthew Charles Hurd, LCSW Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 250 North Ave, Business Office, Athens, GA 30601 Phone: 706-542-9700 Fax: 706-227-7249 | |
Shannen Faye Malutinok, LCSW Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 1 Huntington Rd Ste 103, Athens, GA 30606 Phone: 706-850-7041 Fax: 706-850-7042 | |
Kiva Fisher-green, LMSW Clinical Social Worker Medicare: Medicare Enrolled Practice Location: 250 North Ave, Athens, GA 30601 Phone: 706-389-6789 Fax: 706-227-7249 | |
Nikiki Stovall, LCSW Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 405 Gaines School Rd Ste C4, Athens, GA 30605 Phone: 706-389-9855 | |
Ms. Bonnie G Rocker, Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 250 Bray St, Athens, GA 30601 Phone: 706-389-6789 |