Basic Information
| Provider Information | |||||||||
| NPI: | 1871034413 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | PRICE | ||||||||
| FirstName: | MICHELE | ||||||||
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| Credential: | LCSW | ||||||||
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| Mailing Information | |||||||||
| Address1: | 12 EXECUTIVE PARK DR NE | ||||||||
| Address2: | 5TH FLOOR | ||||||||
| City: | ATLANTA | ||||||||
| State: | GA | ||||||||
| PostalCode: | 303292206 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4047127227 | ||||||||
| FaxNumber: | 4047120278 | ||||||||
| Practice Location | |||||||||
| Address1: | 12 EXECUTIVE PARK DR NE | ||||||||
| Address2: | 5TH FLOOR | ||||||||
| City: | ATLANTA | ||||||||
| State: | GA | ||||||||
| PostalCode: | 303292206 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4047127227 | ||||||||
| FaxNumber: | 4047120278 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 03/15/2017 | ||||||||
| LastUpdateDate: | 03/15/2017 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 1041C0700X | CSW005923 | GA | Y | Behavioral Health & Social Service Providers | Social Worker | Clinical |
No ID Information.