Provider Demographics
NPI:1356860720
Name:MARSTON, ELIZABETH OLDS (LCSW)
Entity Type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:OLDS
Last Name:MARSTON
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 1:524 HILL ST
Mailing Address - Street 2:
Mailing Address - City:ATHENS
Mailing Address - State:GA
Mailing Address - Zip Code:30606-3032
Mailing Address - Country:US
Mailing Address - Phone:706-521-6511
Mailing Address - Fax:
Practice Address - Street 1:524 HILL ST
Practice Address - Street 2:
Practice Address - City:ATHENS
Practice Address - State:GA
Practice Address - Zip Code:30606-3032
Practice Address - Country:US
Practice Address - Phone:706-521-6511
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-09-16
Last Update Date:2022-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GACSW0061721041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical