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Individual

SEAN P DOUGHERTY

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
LMSW

Contact information

Practice address
1650 COUNTY SERVICES PKWY SW, MARIETTA, GA 30008-4010
(770) 514-2422
Mailing address
1650 COUNTY SERVICES PKWY SW, MARIETTA, GA 30008-4010

Taxonomy

Speciality
Code
Description
License number
State
104100000X
Social Worker
MSW009289
GA
1041C0700X
Clinical Social Worker
Primary
CSW007864
GA

Other

Enumeration date
03/15/2020
Last updated
03/15/2022
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