Healthcare Provider Details

I. General information

NPI: 1891060786
Provider Name (Legal Business Name): ASHLEE NOEL SITZMANN-HEDGES LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/12/2012
Last Update Date: 05/27/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1443 ORLEANS CT
GRAYSON GA
30017-1072
US

IV. Provider business mailing address

4530 S BERKELEY LAKE RD SUITE B
NORCROSS GA
30071-1660
US

V. Phone/Fax

Practice location:
  • Phone: 678-858-3488
  • Fax: 770-446-5643
Mailing address:
  • Phone: 678-858-3488
  • Fax: 770-446-5643

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberCSW005142
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: