Provider Demographics
NPI:1033262035
Name:WINEGAR, NORMAN DEXTER (LCSW)
Entity Type:Individual
Prefix:MR
First Name:NORMAN
Middle Name:DEXTER
Last Name:WINEGAR
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 1:1007 LONGWOOD DR
Mailing Address - Street 2:
Mailing Address - City:WOODSTOCK
Mailing Address - State:GA
Mailing Address - Zip Code:30189-1534
Mailing Address - Country:US
Mailing Address - Phone:678-569-2161
Mailing Address - Fax:
Practice Address - Street 1:3901 ROSWELL RD
Practice Address - Street 2:#340
Practice Address - City:MARIETTA
Practice Address - State:GA
Practice Address - Zip Code:30062-8809
Practice Address - Country:US
Practice Address - Phone:678-569-2161
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNLDC0000000350101YA0400X
GACSW0032621041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
Not Answered1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical