MEDICARE: WISDOMS HOUSE INC

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

General Provider Information

NPI Number	:	1578410825
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	WISDOMS HOUSE INC

Provider Business Mailing Address
First Line	:	400 GALLERIA PKWY SE
Second Line	:
City	:	ATLANTA
State	:	GA
Zip	:	30339-5980
Country	:	US
Telephone Number	:	678-534-5887
Fax Number	:

Provider Business Practice Location Address
First Line	:	400 GALLERIA PKWY SE
Second Line	:
City	:	ATLANTA
State	:	GA
Zip	:	30339-5980
Country	:	US
Telephone Number	:	678-534-5887
Fax Number	:

Authorized Official
Title or Position	:	CEO/LCSW
Name	:	SOPHIA PHILOGENE
Credential	:
Telephone Number	:	407-914-4956

Provider Enumeration Date	:	03/16/2026
Last Update Date	:	03/16/2026

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Directions to “WISDOMS HOUSE INC ” Practice Location

Language	Start Address	Practice Location

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