Provider Demographics
NPI:1548202351
Name:HOHN, CHANDRA (LCSW, MAC)
Entity Type:Individual
Prefix:
First Name:CHANDRA
Middle Name:
Last Name:HOHN
Suffix:
Gender:F
Credentials:LCSW, MAC
Other - Prefix:
Other - First Name:CHANDRA
Other - Middle Name:
Other - Last Name:HOHN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LCSW, MAC
Mailing Address - Street 1:175 GWINNETT DR
Mailing Address - Street 2:
Mailing Address - City:LAWRENCEVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30045-8444
Mailing Address - Country:US
Mailing Address - Phone:678-209-2309
Mailing Address - Fax:770-822-1698
Practice Address - Street 1:175 GWINNETT DR
Practice Address - Street 2:
Practice Address - City:LAWRENCEVILLE
Practice Address - State:GA
Practice Address - Zip Code:30045-8444
Practice Address - Country:US
Practice Address - Phone:678-209-2309
Practice Address - Fax:770-822-1698
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-13
Last Update Date:2013-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GACSW0033721041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA52145943-002OtherBLUECROSS/BLUESHIELD
GAQ42842Medicare UPIN