Provider Demographics
NPI:1447378971
Name:BEJACMAR-DIDIER, MARIA L (LCSW)
Entity Type:Individual
Prefix:DR
First Name:MARIA
Middle Name:L
Last Name:BEJACMAR-DIDIER
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 1:2608 HIGH ST SW
Mailing Address - Street 2:
Mailing Address - City:CONYERS
Mailing Address - State:GA
Mailing Address - Zip Code:30094-6843
Mailing Address - Country:US
Mailing Address - Phone:678-849-0324
Mailing Address - Fax:
Practice Address - Street 1:2385 WALL ST SE
Practice Address - Street 2:
Practice Address - City:CONYERS
Practice Address - State:GA
Practice Address - Zip Code:30013-2187
Practice Address - Country:US
Practice Address - Phone:678-849-0324
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-03-26
Last Update Date:2008-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GACSW0037421041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical