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Organization
LUTHERAN SERVICES OF GEORGIA, INC..
Active
Organization
LUTHERAN SERVICES OF GEORGIA, INC..
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. LUCY MAE CANNON LCSW (CLINICAL DIRECTOR)
(404) 875-0201
Entity
Organization
Contact information
Practice address
100 EDGEWOOD AVE NE, SUITE 1800, ATLANTA, GA 30303-3026
(404) 875-0201
(404) 591-1030
Mailing address
100 EDGEWOOD AVE NE, SUITE 1800, ATLANTA, GA 30303-3026
(404) 875-0201
(404) 591-1030
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
—
—
101YM0800X
Mental Health Counselor
Primary
—
—
1041C0700X
Clinical Social Worker
—
—
Other
Enumeration date
05/10/2013
Last updated
08/13/2013
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