MEDICARE: MR. ADAM M LESSER MSW

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1041C0700X	Clinical Social Worker	CSW004012	GA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	7799218	OTHER	MA	AETNA
2	010547	OTHER	MA	VALUE OPTIONS
3	361138	OTHER	MA	MHN
4	263860000	OTHER	MA	CMSP

General Provider Information

NPI Number	:	1447240288
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. ADAM M LESSER MSW

Provider Business Mailing Address
First Line	:	5160 JOEL CT
Second Line	:
City	:	ATLANTA
State	:	GA
Zip	:	30360-1412
Country	:	US
Telephone Number	:	617-285-0149
Fax Number	:	815-572-0120

Provider Business Practice Location Address
First Line	:	5160 JOEL COURT
Second Line	:
City	:	ATLANTA
State	:	GA
Zip	:	30360-1412
Country	:	US
Telephone Number	:	617-285-0149
Fax Number	:	815-572-0120

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/24/2005
Last Update Date	:	09/10/2008

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