Mrs Shannon Davidson, LCSW | |
126 Enterprise Path Ste 201, Hiram, GA 30141-2654 | |
(678) 682-0405 | |
Not Available |
Full Name | Mrs Shannon Davidson |
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Gender | Female |
Speciality | Social Worker - Clinical |
Location | 126 Enterprise Path Ste 201, Hiram, Georgia |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1235839820 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
1041C0700X | Social Worker - Clinical | CSW008497 (Georgia) | Primary |
Entity Name | Thrive Counseling Llc |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1215181300 PECOS PAC ID: 0749458420 Enrollment ID: O20120504000149 |
Mailing Address | Practice Location Address |
---|---|
Mrs Shannon Davidson, LCSW 67 Trace Chain Ct, Hiram, GA 30141-3919 Ph: (678) 682-0405 | Mrs Shannon Davidson, LCSW 126 Enterprise Path Ste 201, Hiram, GA 30141-2654 Ph: (678) 682-0405 |
Kimberly Bryant, Clinical Social Worker Medicare: Medicare Enrolled Practice Location: 126 Enterprise Path, Hiram, GA 30141 Phone: 678-567-0920 | |
Timothy James Whailen, LCSW Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 107 Enterprise Path Ste 301, Hiram, GA 30141 Phone: 706-509-0130 Fax: 706-237-6503 | |
Menyuan Jordan, LCSW Clinical Social Worker Medicare: Accepting Medicare Assignments Practice Location: 107 Enterprise Path Ste 300, Hiram, GA 30141 Phone: 678-588-7982 | |
Edward Miguel Valentin, LCSW Clinical Social Worker Medicare: Accepting Medicare Assignments Practice Location: 126 Enterprise Path Ste 104b, Hiram, GA 30141 Phone: 770-256-7078 |