Susan Ahearn, L.C.S.W.

Individual provider Active NPI Social Worker · Atlanta, GA

NPI 1689117178 · NPPES record last updated Dec 1, 2016

Key facts

NPI
1689117178
Entity type
Individual (NPI type 1)
Primary specialty
Social Worker 104100000X
License
CSW 003143 (GA)
Practice address
824 Greenwood Ave NE Apt 12
Atlanta, GA 30306-3739
Phone
(678) 927-0632
NPI assigned
Dec 1, 2016
Sex
Female
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
CSW 003143GAMDSocial Worker

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X CSW 003143 GA Yes

Addresses

Primary practice location

824 Greenwood Ave NE Apt 12
Atlanta, GA 30306-3739

Mailing address

824 Greenwood Ave NE Apt 12
Atlanta, GA 30306-3739
Phone (678) 927-0632

Other providers in Atlanta, GA

All providers in Atlanta, GA · Social Worker in Georgia

Sources for this page

Verify at the official NPI Registry.