Individual
SHELLY ELYSE EISENSTADT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
4415 KINGS WAY NE, MARIETTA, GA 30067-3633
(404) 518-5325
Mailing address
4415 KINGS WAY NE, MARIETTA, GA 30067-3633
(404) 518-5325
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
CSW004993
GA
Other
Enumeration date
03/31/2023
Last updated
03/31/2023
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