Provider Demographics
NPI:1356230270
Name:ULZEN SETRAKIAN, ADWOA (MSW)
Entity type:Individual
Prefix:MS
First Name:ADWOA
Middle Name:
Last Name:ULZEN SETRAKIAN
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3845 SIDESTREET
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30341-1774
Mailing Address - Country:US
Mailing Address - Phone:252-412-0202
Mailing Address - Fax:
Practice Address - Street 1:621 NORTH AVE NE STE D100
Practice Address - Street 2:
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30308-2867
Practice Address - Country:US
Practice Address - Phone:252-412-0202
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-07-03
Last Update Date:2025-07-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA7732251041S0200X
GAMSW010721104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker
No1041S0200XBehavioral Health & Social Service ProvidersSocial WorkerSchoolGroup - Multi-Specialty