Provider Demographics
NPI:1578769899
Name:PAMELA E, FLATOW, LCSW, LLC
Entity Type:Organization
Organization Name:PAMELA E, FLATOW, LCSW, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:PAMELA
Authorized Official - Middle Name:E
Authorized Official - Last Name:FLATOW
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:770-662-6900
Mailing Address - Street 1:5435 SUGARLOAF PKWY
Mailing Address - Street 2:SUITE 1104
Mailing Address - City:LAWRENCEVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30043-7831
Mailing Address - Country:US
Mailing Address - Phone:770-662-6900
Mailing Address - Fax:678-985-9485
Practice Address - Street 1:5435 SUGARLOAF PKWY
Practice Address - Street 2:SUITE 1104
Practice Address - City:LAWRENCEVILLE
Practice Address - State:GA
Practice Address - Zip Code:30043-7831
Practice Address - Country:US
Practice Address - Phone:770-662-6900
Practice Address - Fax:678-985-9485
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-24
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GACSW0011631041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty