Individual
SHARDAY A FIELDS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
650 PONCE DE LEON AVE NE, STE 300-1063, ATLANTA, GA 30308-1804
(678) 837-6460
Mailing address
650 PONCE DE LEON AVE NE, STE 300-1063, ATLANTA, GA 30308-1804
(404) 290-1667
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
MSW007172
GA
104100000X
Social Worker
LMSW
GA
1041C0700X
Clinical Social Worker
Primary
CSW007771
GA
Other
Enumeration date
03/09/2020
Last updated
10/13/2021
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