Healthcare Provider Details

I. General information

NPI: 1891911194
Provider Name (Legal Business Name): ELIZABETH A RESSLER-CRAIG LICSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/17/2007
Last Update Date: 03/17/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

115 MILL ST
BELMONT MA
02478-1064
US

IV. Provider business mailing address

3500 PIEDMONT RD NE SUITE 775
ATLANTA GA
30305-1507
US

V. Phone/Fax

Practice location:
  • Phone: 800-333-0338
  • Fax:
Mailing address:
  • Phone: 404-351-2008
  • Fax: 404-351-0243

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberCSW002495
License Number StateGA
# 2
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number120474
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: