Healthcare Provider Details

I. General information

NPI: 1952192742
Provider Name (Legal Business Name): FRANK EADY LCSW
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/13/2025
Last Update Date: 05/13/2025
Certification Date: 05/13/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2940 JOHNSON FERRY RD STE B-127
MARIETTA GA
30062-8361
US

IV. Provider business mailing address

2940 JOHNSON FERRY RD STE B-127
MARIETTA GA
30062-8361
US

V. Phone/Fax

Practice location:
  • Phone: 678-637-7166
  • Fax:
Mailing address:
  • Phone: 678-637-7166
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberCSW009255
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: