| Emotional Wellness Of Roswell | |
|
2002 Macy Dr Roswell GA 30076-6346 | |
| (410) 440-3074 | |
| Not Available |
| Full Name | Emotional Wellness Of Roswell |
|---|---|
| Speciality | Social Worker |
| Location | 2002 Macy Dr, Roswell, Georgia |
| Authorized Official Name and Position | Sharon Peterson (OWNER) |
| Authorized Official Contact | 4104403074 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Emotional Wellness Of Roswell 1435 Lyndhurst Way Roswell GA 30075-2574 Ph: (410) 440-3074 | Emotional Wellness Of Roswell 2002 Macy Dr Roswell GA 30076-6346 Ph: (410) 440-3074 |
| NPI Number | 1841927407 |
|---|---|
| Provider Enumeration Date | 08/04/2022 |
| Last Update Date | 10/08/2022 |
| Certification Date | 10/08/2022 |
| Medicare PECOS PAC ID | 1254717986 |
|---|---|
| Medicare Enrollment ID | O20221004002670 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1841927407 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
| Provider Name | Sharon Peterson |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1841324324 PECOS PAC ID: 8729049838 Enrollment ID: I20181022001937 |
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