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Organization
SUE HOWELL-FAFCHAMPS LCSW LLC
Active
Organization
SUE HOWELL-FAFCHAMPS LCSW LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. SUE HOWELL-FAFCHAMPS LCSW (SOLE OWNER/MEMBER)
(803) 719-2190
Entity
Organization
Contact information
Practice address
3711 EXECUTIVE CENTER DR, SUITE 202 OFFICE 1, MARTINEZ, GA 30907-0951
(803) 719-2190
(706) 432-9095
Mailing address
3711 EXECUTIVE CENTER DR, SUITE 202 OFFICE 1, MARTINEZ, GA 30907-0951
(803) 719-2190
(706) 432-9095
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
CSW004238
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
202I803969
MEDICARE PTAN 202I803969
GA
Enumeration date
05/06/2014
Last updated
05/06/2014
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