Healthcare Provider Details

I. General information

NPI: 1538421771
Provider Name (Legal Business Name): APRIL MARIE BEFORT LMSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/13/2012
Last Update Date: 06/13/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

175 GWINNETT DR
LAWRENCEVILLE GA
30046-8444
US

IV. Provider business mailing address

4262 PLEASANT LAKE VILLAGE LN APARTMENT F
DULUTH GA
30096-7129
US

V. Phone/Fax

Practice location:
  • Phone: 678-389-0322
  • Fax:
Mailing address:
  • Phone: 678-389-0322
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License NumberMSW005642
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: