Individual
CARLY KOHLER SHOCKLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
740 PRINCE AVE STE 14, ATHENS, GA 30606-5903
(706) 308-7664
Mailing address
106 TRINITY POND RD, WINTERVILLE, GA 30683-3311
(404) 345-7224
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
MSW007910
GA
1041C0700X
Clinical Social Worker
Primary
CSW007309
—
Other
Enumeration date
10/15/2018
Last updated
03/20/2022
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