Provider Demographics
NPI:1265682223
Name:DUSZYNSKI, LANDA MARIE (MSW, LCSW)
Entity Type:Individual
Prefix:
First Name:LANDA
Middle Name:MARIE
Last Name:DUSZYNSKI
Suffix:
Gender:F
Credentials:MSW, LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:805 FAIRBROOK LN
Mailing Address - Street 2:
Mailing Address - City:ROSWELL
Mailing Address - State:GA
Mailing Address - Zip Code:30075-1354
Mailing Address - Country:US
Mailing Address - Phone:470-757-2696
Mailing Address - Fax:
Practice Address - Street 1:12590 BROADWELL RD STE 1002B
Practice Address - Street 2:
Practice Address - City:ALPHARETTA
Practice Address - State:GA
Practice Address - Zip Code:30004-6700
Practice Address - Country:US
Practice Address - Phone:470-757-2696
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-09-26
Last Update Date:2023-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCC0061241041C0700X
GACSW0076881041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical