Provider Demographics
NPI:1063853976
Name:TATRO, PATRICIA (LCSW)
Entity Type:Individual
Prefix:MS
First Name:PATRICIA
Middle Name:
Last Name:TATRO
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:403 W PONCE DE LEON AVE STE 102
Mailing Address - Street 2:
Mailing Address - City:DECATUR
Mailing Address - State:GA
Mailing Address - Zip Code:30030-2445
Mailing Address - Country:US
Mailing Address - Phone:404-277-0026
Mailing Address - Fax:404-687-0281
Practice Address - Street 1:403 W PONCE DE LEON AVE STE 102
Practice Address - Street 2:
Practice Address - City:DECATUR
Practice Address - State:GA
Practice Address - Zip Code:30030-2445
Practice Address - Country:US
Practice Address - Phone:404-277-0026
Practice Address - Fax:404-687-0281
Is Sole Proprietor?:Yes
Enumeration Date:2013-07-09
Last Update Date:2022-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GACSW0019401041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical