Provider Demographics
NPI:1093032476
Name:RAHEJA, ROMA (LCSW)
Entity Type:Individual
Prefix:
First Name:ROMA
Middle Name:
Last Name:RAHEJA
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 1:1860 SANDY PLANS RD
Mailing Address - Street 2:SUITE 204, PMB 2333
Mailing Address - City:MARIETTA
Mailing Address - State:GA
Mailing Address - Zip Code:30066-7864
Mailing Address - Country:US
Mailing Address - Phone:404-594-1393
Mailing Address - Fax:
Practice Address - Street 1:1860 SANDY PLAINS RD STE 2042333
Practice Address - Street 2:
Practice Address - City:MARIETTA
Practice Address - State:GA
Practice Address - Zip Code:30066-7833
Practice Address - Country:US
Practice Address - Phone:404-594-1393
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-04-26
Last Update Date:2022-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA0036461041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical