Organization
COMMON EARTHLING
Active
Organization subpart
No
Provider details
NPI number
Authorized official
REBECCA WILSON LMSW (CEO)
(404) 664-6055
Entity
Organization
Contact information
Practice address
3715 NORTHSIDE PARKWAY NW, BUILDING 100-SUITE 500, ATLANTA, GA 30327
(404) 793-0924
(601) 568-9733
Mailing address
3715 NORTHSIDE PARKWAY NW, BUILDING 100-SUITE 500, ATLANTA, GA 30327
(404) 793-0924
(601) 568-9733
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1609544832
LMSW
GA
Enumeration date
12/02/2022
Last updated
12/02/2022
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