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General NPI Number Information
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NPI Number | 1578769899
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Entity Type | Organization
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Legal Business Name | PAMELA E, FLATOW, LCSW, LLC
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Dates
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Enumeration Date | 06/24/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 5435 SUGARLOAF PKWY SUITE 1104
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City | LAWRENCEVILLE
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State | GA
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Zip | 30043-7831
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Country | US
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Telephone | 770-662-6900
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Fax | 678-985-9485
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Provider Business Mailing Address
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Address Line | 5435 SUGARLOAF PKWY SUITE 1104
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City | LAWRENCEVILLE
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State | GA
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Zip | 30043-7831
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Country | US
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Telephone | 770-662-6900
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Fax | 678-985-9485
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Authorized Official
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Title or Position | PRESIDENT
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Name | MRS. PAMELA E FLATOW
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Credential | LCSW
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Telephone | 770-662-6900
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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 | CSW001163
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License Number State | GA
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