Provider Demographics
NPI:1083495238
Name:AICHER, BRIAN ADAM (LCSW)
Entity Type:Individual
Prefix:
First Name:BRIAN
Middle Name:ADAM
Last Name:AICHER
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 1:2230 TOWNE LAKE PKWY STE 200
Mailing Address - Street 2:
Mailing Address - City:WOODSTOCK
Mailing Address - State:GA
Mailing Address - Zip Code:30189-5540
Mailing Address - Country:US
Mailing Address - Phone:404-713-4280
Mailing Address - Fax:
Practice Address - Street 1:2230 TOWNE LAKE PKWY STE 200
Practice Address - Street 2:
Practice Address - City:WOODSTOCK
Practice Address - State:GA
Practice Address - Zip Code:30189-5540
Practice Address - Country:US
Practice Address - Phone:404-713-4280
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-10-12
Last Update Date:2023-10-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GACSW0070051041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical