Individual
JESSICA AUSTIN NORTHROP
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
323 VINE CREEK DR, ACWORTH, GA 30101-5908
(470) 246-3717
(770) 928-5731
Mailing address
8910 MAIN ST, WOODSTOCK, GA 30188-4916
(470) 246-3717
(770) 928-5731
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
CSW004865
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1497909998
—
VA
Enumeration date
11/11/2008
Last updated
03/18/2013
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