Organization
COLLEEN L HAGAN LCSW INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. COLLEEN L HAGAN LCSW (PRESIDENT)
(678) 469-1409
Entity
Organization
Contact information
Practice address
1640 POWERS FERRY RD SE, BLDG 29 SUITE 300, MARIETTA, GA 30067-5491
(678) 469-1409
(770) 858-1700
Mailing address
1640 POWERS FERRY RD SE, BLDG 29 SUITE 300, MARIETTA, GA 30067-5491
(678) 469-1409
(770) 858-1700
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
CSW001379
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
089005
VALUE OPTIONS
GA
01
—
1295714442
NPI COLLEEN L HAGAN INDIV
GA
Enumeration date
12/26/2006
Last updated
08/22/2020
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