Organization
LUTHERAN SERVICES OF GEORGIA, INC..
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. LUCY MAE CANNON LCSW (CLINICAL DIRECTOR)
(404) 875-0201
Entity
Organization
Contact information
Practice address
100 EDGEWOOD AVE NE, SUITE 1800, ATLANTA, GA 30303-3026
(404) 875-0201
(404) 591-1030
Mailing address
100 EDGEWOOD AVE NE, SUITE 1800, ATLANTA, GA 30303-3026
(404) 875-0201
(404) 591-1030
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
—
—
101YM0800X
Mental Health Counselor
Primary
—
—
1041C0700X
Clinical Social Worker
—
—
Other
Enumeration date
05/10/2013
Last updated
08/13/2013
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