Individual
MR. JOHN W. GEORGE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LCSW, SWL,
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
33000266A
IN
1041C0700X
Clinical Social Worker
Primary
34000629A
IN
106H00000X
Marriage & Family Therapist
35000286A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000184322
ANTHEM
IN
01
—
138835000
MAGELLAN BEHAVIORAL
IN
Enumeration date
07/05/2006
Last updated
05/17/2017
Update your record
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