Provider Demographics
NPI:1023556917
Name:ST.GEORGE, STUART WORTH (LCSW)
Entity Type:Individual
Prefix:MR
First Name:STUART
Middle Name:WORTH
Last Name:ST.GEORGE
Suffix:
Gender:M
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:139 RENAISSANCE PKWY NE
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30308-2324
Mailing Address - Country:US
Mailing Address - Phone:404-874-2224
Mailing Address - Fax:404-874-2353
Practice Address - Street 1:139 RENAISSANCE PKWY NE
Practice Address - Street 2:
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30308-2324
Practice Address - Country:US
Practice Address - Phone:404-874-2224
Practice Address - Fax:404-874-2353
Is Sole Proprietor?:No
Enumeration Date:2017-02-10
Last Update Date:2017-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GACSW0050711041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical