Individual
SHAKIRAH FORDE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
1770 INDIAN TRAIL LILBURN RD STE 120, NORCROSS, GA 30093
(678) 888-5904
Mailing address
538 COUNTRY LAKE DR, MCDONOUGH, GA 30252-2683
(347) 634-0077
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
CSW006433
GA
1041C0700X
Clinical Social Worker
Primary
CSW006433
GA
Other
Enumeration date
08/31/2012
Last updated
11/21/2019
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