Provider Demographics
NPI:1083130736
Name:WINEBURG, HANNAH R (LMSW)
Entity Type:Individual
Prefix:MS
First Name:HANNAH
Middle Name:R
Last Name:WINEBURG
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1827 DONNALEE AVE SE
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30316-2303
Mailing Address - Country:US
Mailing Address - Phone:336-708-0750
Mailing Address - Fax:
Practice Address - Street 1:4939 LOWER ROSWELL RD
Practice Address - Street 2:
Practice Address - City:MARIETTA
Practice Address - State:GA
Practice Address - Zip Code:30068-4338
Practice Address - Country:US
Practice Address - Phone:336-708-0750
Practice Address - Fax:336-708-0750
Is Sole Proprietor?:Yes
Enumeration Date:2017-08-15
Last Update Date:2017-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA007255104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes104100000XBehavioral Health & Social Service ProvidersSocial WorkerGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA1548663644OtherPARKAIRE CONSULTANTS, INC.