Provider Demographics
NPI:1528225901
Name:BIROS, ELLEN (MS, LCSW)
Entity Type:Individual
Prefix:
First Name:ELLEN
Middle Name:
Last Name:BIROS
Suffix:
Gender:F
Credentials:MS, LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2235 SAXONY TRCE
Mailing Address - Street 2:
Mailing Address - City:ALPHARETTA
Mailing Address - State:GA
Mailing Address - Zip Code:30005-2235
Mailing Address - Country:US
Mailing Address - Phone:678-793-9367
Mailing Address - Fax:
Practice Address - Street 1:5400 LAUREL SPRINGS PKWY
Practice Address - Street 2:STE 1307
Practice Address - City:SUWANEE
Practice Address - State:GA
Practice Address - Zip Code:30024-6097
Practice Address - Country:US
Practice Address - Phone:678-793-9367
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-05-22
Last Update Date:2023-05-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GACSW0039651041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical