Provider Demographics
NPI:1568151488
Name:JAMES, RAQUEL RENEE (LMSW)
Entity Type:Individual
Prefix:MS
First Name:RAQUEL
Middle Name:RENEE
Last Name:JAMES
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:115 E MAIN ST STE A1B6L
Mailing Address - Street 2:
Mailing Address - City:BUFORD
Mailing Address - State:GA
Mailing Address - Zip Code:30518-5727
Mailing Address - Country:US
Mailing Address - Phone:770-609-7859
Mailing Address - Fax:
Practice Address - Street 1:115 E MAIN ST STE A1B6L
Practice Address - Street 2:
Practice Address - City:BUFORD
Practice Address - State:GA
Practice Address - Zip Code:30518-5727
Practice Address - Country:US
Practice Address - Phone:770-609-7859
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-05-05
Last Update Date:2023-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAMSW008621104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker