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Individual

BRANDI CELESTE RUTAN

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
LCSW

Contact information

Practice address
40 TOWN SQ UNIT H, BLAIRSVILLE, GA 30512-8503
(706) 781-1409
(706) 946-2044
Mailing address
40 TOWN SQ UNIT H, BLAIRSVILLE, GA 30512-8503
(706) 781-1409
(706) 946-2044

Taxonomy

Speciality
Code
Description
License number
State
104100000X
Social Worker
11720
SC
104100000X
Social Worker
C009934
NC
1041C0700X
Clinical Social Worker
C009934
NC
1041C0700X
Clinical Social Worker
Primary
CSW005851
GA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
11720
LICENSED INDEPENDENT SOCIAL WORKER
SC
01
C009934
LICENSED CLINICAL SOCIAL WORKER
NC
01
CSW005851
LICENSED CLINICAL SOCIAL WORKER
GA
Enumeration date
03/14/2007
Last updated
05/06/2026
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