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NPI Code Detail

MEDICARE: MRS. MONIEK SHANELL GARSIDE LCSW, MBA

MEDICARE: MRS. MONIEK SHANELL GARSIDE LCSW, MBA
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
11041C0700XClinical Social WorkerCSW005281GA

General Provider Information

NPI Number : 1568904456
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. MONIEK SHANELL GARSIDE LCSW, MBA
Provider Business Mailing Address
First Line : PO BOX 871296
Second Line :
City : STONE MOUNTAIN
State : GA
Zip : 30087-0033
Country : US
Telephone Number : 404-807-2770
Fax Number : 404-829-2400
Provider Business Practice Location Address
First Line : 2751 BUFORD HWY NE STE 700
Second Line :
City : ATLANTA
State : GA
Zip : 30324-5510
Country : US
Telephone Number : 404-807-2770
Fax Number : 404-829-2400
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/09/2016
Last Update Date : 06/02/2021

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