MEDICARE: BRIANA GIDDENS LCSW, LICSW, ATR

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	119108	MA
2	1041C0700X	Clinical Social Worker	SW 8619	FL
3	1041C0700X	Clinical Social Worker	CSW003857	GA

General Provider Information

NPI Number	:	1932333051
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	BRIANA GIDDENS LCSW, LICSW, ATR

Provider Business Mailing Address
First Line	:	5400 GLENRIDGE DR UNIT 421784
Second Line	:
City	:	ATLANTA
State	:	GA
Zip	:	30342-7571
Country	:	US
Telephone Number	:	678-753-4790
Fax Number	:	678-730-3937

Provider Business Practice Location Address
First Line	:	10 GLENLAKE PKWY STE 130
Second Line	:
City	:	ATLANTA
State	:	GA
Zip	:	30328-3495
Country	:	US
Telephone Number	:	678-753-4790
Fax Number	:	678-730-3937

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

Provider Enumeration Date	:	05/04/2009
Last Update Date	:	04/28/2022

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