MEDICARE: MS. HANNAH GARRICK LCSW, LMFT, BCD

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	#000309	GA
2	106H00000X	Marriage & Family Therapist	#000300	GA

General Provider Information

NPI Number	:	1457564288
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. HANNAH GARRICK LCSW, LMFT, BCD

Provider Business Mailing Address
First Line	:	6065 ROSWELL RD NE
Second Line	:	#705
City	:	ATLANTA
State	:	GA
Zip	:	30328-4011
Country	:	US
Telephone Number	:	404-255-6409
Fax Number	:	404-255-3794

Provider Business Practice Location Address
First Line	:	6065 ROSWELL RD NE
Second Line	:	#705
City	:	ATLANTA
State	:	GA
Zip	:	30328-4011
Country	:	US
Telephone Number	:	404-255-6409
Fax Number	:	404-255-3794

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

Provider Enumeration Date	:	05/08/2007
Last Update Date	:	03/06/2011

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