Provider Demographics
NPI:1134323652
Name:CHRUSZCZ, HOLLY JOANNE (LCSW)
Entity Type:Individual
Prefix:MRS
First Name:HOLLY
Middle Name:JOANNE
Last Name:CHRUSZCZ
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:2300 LAKE PARK DR SE
Mailing Address - Street 2:SUITE 100
Mailing Address - City:SMYRNA
Mailing Address - State:GA
Mailing Address - Zip Code:30080-4076
Mailing Address - Country:US
Mailing Address - Phone:404-541-3015
Mailing Address - Fax:678-556-1974
Practice Address - Street 1:2300 LAKE PARK DR SE
Practice Address - Street 2:SUITE 100
Practice Address - City:SMYRNA
Practice Address - State:GA
Practice Address - Zip Code:30080-4076
Practice Address - Country:US
Practice Address - Phone:404-541-3015
Practice Address - Fax:678-556-1974
Is Sole Proprietor?:No
Enumeration Date:2007-06-11
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
GACSW0031731041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical