| Sue Howell-fafchamps Lcsw Llc | |
|
3711 Executive Center Dr Suite 202 Office 1 Martinez GA 30907-0951 | |
| (803) 719-2190 | |
| (706) 432-9095 |
| Full Name | Sue Howell-fafchamps Lcsw Llc |
|---|---|
| Speciality | Social Worker - Clinical |
| Location | 3711 Executive Center Dr, Martinez, Georgia |
| Authorized Official Name and Position | Sue Howell-fafchamps (SOLE OWNER/MEMBER) |
| Authorized Official Contact | 8037192190 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Sue Howell-fafchamps Lcsw Llc 3711 Executive Center Dr Suite 202 Office 1 Martinez GA 30907-0951 Ph: (803) 719-2190 | Sue Howell-fafchamps Lcsw Llc 3711 Executive Center Dr Suite 202 Office 1 Martinez GA 30907-0951 Ph: (803) 719-2190 |
| NPI Number | 1639589179 |
|---|---|
| Provider Enumeration Date | 05/06/2014 |
| Last Update Date | 05/06/2014 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1639589179 | NPI | - | NPPES |
| 202I803969 | Other | GA | MEDICARE PTAN 202I803969 |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | CSW004238 (Georgia) | Primary |
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