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NPI Code Detail

MEDICARE: CHRISTINE M BURRELL LCSW

MEDICARE: CHRISTINE M BURRELL LCSW
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
11041C0700XClinical Social WorkerCSW002958GA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1700927407
Entity Type Code : Individual
Provider Name (Legal Business Name) : CHRISTINE M BURRELL LCSW
Provider Business Mailing Address
First Line : 2386 CLOWER ST
Second Line : BLDG C, SUITE 100
City : SNELLVILLE
State : GA
Zip : 30078-6134
Country : US
Telephone Number : 770-985-2050
Fax Number : 770-985-2050
Provider Business Practice Location Address
First Line : 2386 CLOWER ST
Second Line : BLDG C, SUITE 100
City : SNELLVILLE
State : GA
Zip : 30078-6134
Country : US
Telephone Number : 770-985-2050
Fax Number : 770-985-2050
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/08/2007
Last Update Date : 05/18/2011

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Directions to “ CHRISTINE M BURRELL LCSW” Practice Location

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