Provider Demographics
NPI:1366674087
Name:WOODFIN J. THRELKELD, MSW, LCSW, INC.
Entity Type:Organization
Organization Name:WOODFIN J. THRELKELD, MSW, LCSW, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:WOODFIN
Authorized Official - Middle Name:JACKSON
Authorized Official - Last Name:THRELKELD
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:404-325-3992
Mailing Address - Street 1:2250 N DRUID HILLS RD NE
Mailing Address - Street 2:SUITE 232
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30329-3192
Mailing Address - Country:US
Mailing Address - Phone:404-325-3992
Mailing Address - Fax:404-325-5310
Practice Address - Street 1:2250 N DRUID HILLS RD NE
Practice Address - Street 2:SUITE 232
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30329-3192
Practice Address - Country:US
Practice Address - Phone:404-325-3992
Practice Address - Fax:404-325-5310
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-08-13
Last Update Date:2009-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GACSW0020021041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty