| Abigail S. Holbrook, Msw, Lcsw, Llc | |
|
1551 Jennings Mill Rd Suite 3200 A Watkinsville GA 30677-7244 | |
| (706) 424-4814 | |
| Not Available |
| Full Name | Abigail S. Holbrook, Msw, Lcsw, Llc |
|---|---|
| Speciality | Social Worker |
| Location | 1551 Jennings Mill Rd, Watkinsville, Georgia |
| Authorized Official Name and Position | Abigail Susannah Holbrook (OWNER) |
| Authorized Official Contact | 7064244814 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Abigail S. Holbrook, Msw, Lcsw, Llc Po Box 7742 Athens GA 30604-7742 Ph: (706) 424-4814 | Abigail S. Holbrook, Msw, Lcsw, Llc 1551 Jennings Mill Rd Suite 3200 A Watkinsville GA 30677-7244 Ph: (706) 424-4814 |
| NPI Number | 1952782799 |
|---|---|
| Provider Enumeration Date | 06/17/2015 |
| Last Update Date | 08/19/2015 |
| Medicare PECOS PAC ID | 6709192735 |
|---|---|
| Medicare Enrollment ID | O20150904001236 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1952782799 | NPI | - | NPPES |
| 1326154089 | Other | GA | NPI INDIVIDUAL |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | CSW003391 (Georgia) | Primary |
| Provider Name | Abigail Susannah Holbrook |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1326154089 PECOS PAC ID: 0042475964 Enrollment ID: I20120627000432 |
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