Provider Demographics
NPI:1235307703
Name:SPIRO, LOUISE M (LCSW)
Entity Type:Individual
Prefix:
First Name:LOUISE
Middle Name:M
Last Name:SPIRO
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 1:3912 CEDAR CIR
Mailing Address - Street 2:
Mailing Address - City:TUCKER
Mailing Address - State:GA
Mailing Address - Zip Code:30084-7339
Mailing Address - Country:US
Mailing Address - Phone:770-414-9742
Mailing Address - Fax:770-414-8296
Practice Address - Street 1:3912 CEDAR CIR
Practice Address - Street 2:
Practice Address - City:TUCKER
Practice Address - State:GA
Practice Address - Zip Code:30084-7339
Practice Address - Country:US
Practice Address - Phone:770-414-9742
Practice Address - Fax:770-414-8296
Is Sole Proprietor?:Yes
Enumeration Date:2008-02-18
Last Update Date:2008-02-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GACSW0023931041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical