Healthcare Provider Details

I. General information

NPI: 1619175015
Provider Name (Legal Business Name): GEORGIANNA LOUISE AKERS LICSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/06/2007
Last Update Date: 07/30/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8903 KEY PENINSULA HWY N
LAKEBAY WA
98349-9326
US

IV. Provider business mailing address

PO BOX 3
MANCHESTER WA
98353-0003
US

V. Phone/Fax

Practice location:
  • Phone: 360-990-2507
  • Fax:
Mailing address:
  • Phone: 360-990-2507
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberLW00009396
License Number StateWA
# 2
Primary TaxonomyN
Taxonomy Code1041S0200X
TaxonomySchool Social Worker
License Number325760G
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: