Healthcare Provider Details

I. General information

NPI: 1548202351
Provider Name (Legal Business Name): CHANDRA HOHN LCSW, MAC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: CHANDRA HOHN LCSW, MAC

II. Dates (important events)

Enumeration Date: 06/13/2006
Last Update Date: 10/29/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

175 GWINNETT DR
LAWRENCEVILLE GA
30045-8444
US

IV. Provider business mailing address

175 GWINNETT DR
LAWRENCEVILLE GA
30045-8444
US

V. Phone/Fax

Practice location:
  • Phone: 678-209-2309
  • Fax: 770-822-1698
Mailing address:
  • Phone: 678-209-2309
  • Fax: 770-822-1698

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberCSW003372
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: