MEDICARE: MR. JAMES TURLEY HOWARD L.C.S.W., M.DIV.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1041C0700X	Clinical Social Worker	CSW003043	GA

General Provider Information

NPI Number	:	1407069966
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. JAMES TURLEY HOWARD L.C.S.W., M.DIV.

Provider Business Mailing Address
First Line	:	555 RIVERVIEW RD
Second Line	:
City	:	ATHENS
State	:	GA
Zip	:	30606-4829
Country	:	US
Telephone Number	:	706-201-5754
Fax Number	:

Provider Business Practice Location Address
First Line	:	120 E TRINITY PL
Second Line	:
City	:	DECATUR
State	:	GA
Zip	:	30030-3302
Country	:	US
Telephone Number	:	404-378-2300
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/08/2007
Last Update Date	:	10/14/2008

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