Provider Demographics
NPI:1497971113
Name:RUE, PASSIE MCCARTY (LCSW)
Entity Type:Individual
Prefix:
First Name:PASSIE
Middle Name:MCCARTY
Last Name:RUE
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 1:3434 ROSWELL RD NW
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30305-1202
Mailing Address - Country:US
Mailing Address - Phone:404-842-3150
Mailing Address - Fax:404-842-3162
Practice Address - Street 1:3434 ROSWELL RD NW
Practice Address - Street 2:
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30305-1202
Practice Address - Country:US
Practice Address - Phone:404-842-3150
Practice Address - Fax:404-842-3162
Is Sole Proprietor?:No
Enumeration Date:2007-04-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA80BBFZGMedicare ID - Type Unspecified