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General NPI Number Information
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NPI Number | 1225292428
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Entity Type | Organization
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Legal Business Name | JIM LANIER, ACSW (DBA) CENTER FOR FAMILY GROWTH
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Dates
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Enumeration Date | 07/16/2008
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Last Update Date | 07/16/2008
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Provider Practice Location Address
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Address Line | 502 GLOUCESTER ST SUITE 8
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City | BRUNSWICK
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State | GA
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Zip | 31520-7013
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Country | US
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Telephone | 912-264-2369
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Fax | 912-264-2365
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Provider Business Mailing Address
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Address Line | PO BOX 1932
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City | BRUNSWICK
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State | GA
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Zip | 31521-1932
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Country | US
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Telephone | 912-264-2369
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Fax | 912-264-2365
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Authorized Official
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Title or Position | OWNER
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Name | JIM LANIER
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Credential | LCSW
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Telephone | 912-264-2369
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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 |
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License Number State |
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