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General NPI Number Information
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NPI Number | 1437673431
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Entity Type | Organization
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Legal Business Name | RONNIE WEEKS LCSW LLC
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Dates
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Enumeration Date | 08/01/2017
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Last Update Date | 08/01/2017
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Provider Practice Location Address
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Address Line | 4825 OLIVER ROAD
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City | FLOWERY BRANCH
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State | GA
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Zip | 30542
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Country | US
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Telephone | 770-718-6129
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Fax |
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Provider Business Mailing Address
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Address Line | P.O. BOX 7222
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City | CHESTNUT MOUNTAIN
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State | GA
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Zip | 30502
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Country | US
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Telephone | 770-718-6129
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | MR. RONNIE M. WEEKS SR.
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Credential | LCSW
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Telephone | 770-718-6129
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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 | 865
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License Number State | GA
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