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General NPI Number Information
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NPI Number | 1033512686
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Entity Type | Organization
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Legal Business Name | MARLENE BELMONT SUKIENNIK, LCSW, LLC
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Dates
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Enumeration Date | 09/26/2014
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Last Update Date | 09/26/2014
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Provider Practice Location Address
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Address Line | 245 W WIEUCA RD NE STE #140
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City | ATLANTA
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State | GA
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Zip | 30342-3372
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Country | US
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Telephone | 678-720-8921
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Fax |
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Provider Business Mailing Address
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Address Line | 245 W WIEUCA RD NE STE #140
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City | ATLANTA
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State | GA
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Zip | 30342-3372
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | LICENSED CLINICAL SOCIAL WORKER
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Name | MARLENE SUKIENNIK
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Credential |
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Telephone | 678-720-8921
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | CSW005178
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License Number State | GA
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