Provider Demographics
NPI:1568904456
Name:GARSIDE, MONIEK SHANELL (LCSW, MBA)
Entity Type:Individual
Prefix:MRS
First Name:MONIEK
Middle Name:SHANELL
Last Name:GARSIDE
Suffix:
Gender:F
Credentials:LCSW, MBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 871296
Mailing Address - Street 2:
Mailing Address - City:STONE MOUNTAIN
Mailing Address - State:GA
Mailing Address - Zip Code:30087-0033
Mailing Address - Country:US
Mailing Address - Phone:404-807-2770
Mailing Address - Fax:404-829-2400
Practice Address - Street 1:2751 BUFORD HWY NE STE 700
Practice Address - Street 2:
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30324-5510
Practice Address - Country:US
Practice Address - Phone:404-807-2770
Practice Address - Fax:404-829-2400
Is Sole Proprietor?:No
Enumeration Date:2016-11-09
Last Update Date:2021-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GACSW0052811041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical