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General NPI Number Information
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NPI Number | 1699361428
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Entity Type | Individual
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Provider Name | KATIE MORAITAKIS JONES LCSW
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Gender | Female
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Dates
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Enumeration Date | 12/16/2020
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Last Update Date | 04/16/2024
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Provider Practice Location Address
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Address Line | 189 PROFESSIONAL CT SE STE 105
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City | CALHOUN
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State | GA
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Zip | 30701-7051
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Country | US
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Telephone | 678-956-2678
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Fax |
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Provider Business Mailing Address
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Address Line | 192 TIMMS LOOP SE
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City | CALHOUN
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State | GA
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Zip | 30701-4533
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Country | US
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Telephone | 678-956-2678
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 104100000X
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Taxonomy Name | Social Worker
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License Number | MSW008011
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License Number State | GA
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Taxonomy #2
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | CSW007674
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License Number State | GA
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