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Organization

DOROTHY EBERHART LCSW, LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DOROTHY EBERHART LCSW (SOLE MEMBER)
(770) 367-4090
Entity
Organization

Contact information

Practice address
5605 GLENRIDGE DR NE, SUITE 600, ATLANTA, GA 30342-1365
(770) 367-4090
Mailing address
4577 VILLAGE DR, DUNWOODY, GA 30338-5741
(770) 367-4090

Taxonomy

Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
CSW003039
GA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
1821369133
NPI TYPE 1
Enumeration date
05/11/2012
Last updated
05/11/2012
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