Provider Demographics
NPI:1083070304
Name:ATKINSON, BRENDA DARLENE (LCSW)
Entity Type:Individual
Prefix:MS
First Name:BRENDA
Middle Name:DARLENE
Last Name:ATKINSON
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 1:102 PINNACLE WAY
Mailing Address - Street 2:
Mailing Address - City:CARROLLTON
Mailing Address - State:GA
Mailing Address - Zip Code:30117-5254
Mailing Address - Country:US
Mailing Address - Phone:404-434-0618
Mailing Address - Fax:770-258-9128
Practice Address - Street 1:101 KIDSPEACE DR
Practice Address - Street 2:
Practice Address - City:BOWDON
Practice Address - State:GA
Practice Address - Zip Code:30108-3447
Practice Address - Country:US
Practice Address - Phone:770-437-7237
Practice Address - Fax:770-258-9128
Is Sole Proprietor?:Yes
Enumeration Date:2016-01-04
Last Update Date:2016-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GACSW0046491041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical