| Colleen L Hagan Lcsw Inc | |
|
1640 Powers Ferry Rd Se Bldg 29 Suite 300 Marietta GA 30067-5491 | |
| (678) 469-1409 | |
| (770) 858-1700 |
| Full Name | Colleen L Hagan Lcsw Inc |
|---|---|
| Speciality | Social Worker |
| Location | 1640 Powers Ferry Rd Se, Marietta, Georgia |
| Authorized Official Name and Position | Colleen L Hagan (PRESIDENT) |
| Authorized Official Contact | 6784691409 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Colleen L Hagan Lcsw Inc 1640 Powers Ferry Rd Se Bldg 29 Suite 300 Marietta GA 30067-5491 Ph: (678) 469-1409 | Colleen L Hagan Lcsw Inc 1640 Powers Ferry Rd Se Bldg 29 Suite 300 Marietta GA 30067-5491 Ph: (678) 469-1409 |
| NPI Number | 1396800819 |
|---|---|
| Provider Enumeration Date | 12/26/2006 |
| Last Update Date | 08/22/2020 |
| Medicare PECOS PAC ID | 0648267591 |
|---|---|
| Medicare Enrollment ID | O20040430000616 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1396800819 | NPI | - | NPPES |
| 089005 | Other | GA | VALUE OPTIONS |
| 1295714442 | Other | GA | NPI COLLEEN L HAGAN INDIV |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | CSW001379 (Georgia) | Primary |
| Provider Name | Colleen L Hagan |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1295714442 PECOS PAC ID: 3274514500 Enrollment ID: I20040527000416 |
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