Healthcare Provider Details

I. General information

NPI: 1982393898
Provider Name (Legal Business Name): CAWB NONPAR LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/05/2023
Last Update Date: 05/05/2023
Certification Date: 05/05/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1 HUNTINGTON RD STE 703
ATHENS GA
30606-7214
US

IV. Provider business mailing address

1 HUNTINGTON RD STE 703
ATHENS GA
30606-7214
US

V. Phone/Fax

Practice location:
  • Phone: 706-425-8900
  • Fax: 706-425-8600
Mailing address:
  • Phone: 706-425-8900
  • Fax: 706-425-8600

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State

VIII. Authorized Official

Name: CLAIRE N ZIMMERMAN
Title or Position: CO-OWNER
Credential: LCSW
Phone: 706-425-8900