Individual
KOREN RAYMOND
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
3320 OLD JEFFERSON ROAD, BLDG 700, ATHENS, GA 30607
(706) 353-2990
(706) 353-2992
Mailing address
220 HAWTHORNE PARK, ATHENS, GA 30606-2148
(706) 548-0500
(706) 548-3575
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
CSW006661
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00321822A
—
GA
Enumeration date
12/02/2015
Last updated
01/15/2020
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