| Kim Wasley Lcsw Llc | |
|
598 S Milledge Ave Ste 5 Athens GA 30605-1262 | |
| (706) 522-3017 | |
| Not Available |
| Full Name | Kim Wasley Lcsw Llc |
|---|---|
| Speciality | Clinic/center - Adult Mental Health |
| Location | 598 S Milledge Ave Ste 5, Athens, Georgia |
| Authorized Official Name and Position | Kimberly Wasley (OWNER) |
| Authorized Official Contact | 7069749065 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Kim Wasley Lcsw Llc 196 Alps Rd Suite 2, Pmb 196 Athens GA 30606 Ph: (706) 974-9065 | Kim Wasley Lcsw Llc 598 S Milledge Ave Ste 5 Athens GA 30605-1262 Ph: (706) 522-3017 |
| NPI Number | 1154150019 |
|---|---|
| Provider Enumeration Date | 07/30/2024 |
| Last Update Date | 07/30/2024 |
| Certification Date | 07/30/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1154150019 | NPI | - | NPPES |
| 1598239964 | Medicaid | GA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0850X | Clinic/center - Adult Mental Health | (* (Not Available)) | Primary |
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