Healthcare Provider Details

I. General information

NPI: 1538347257
Provider Name (Legal Business Name): DANNEEL HUBBELL LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/05/2008
Last Update Date: 03/09/2022
Certification Date: 03/09/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1 HUNTINGTON RD STE 802
ATHENS GA
30606-7216
US

IV. Provider business mailing address

1 HUNTINGTON RD STE 802
ATHENS GA
30606-7216
US

V. Phone/Fax

Practice location:
  • Phone: 706-530-1231
  • Fax: 855-700-4579
Mailing address:
  • Phone: 706-530-1231
  • Fax: 855-700-4579

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberCSW003642
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: