Provider Demographics
NPI:1598820896
Name:HERRING, GEORGE W JR (LCSW)
Entity Type:Individual
Prefix:MR
First Name:GEORGE
Middle Name:W
Last Name:HERRING
Suffix:JR
Gender:M
Credentials:LCSW
Other - Prefix:MR
Other - First Name:BILL
Other - Middle Name:
Other - Last Name:HERRING
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LCSW
Mailing Address - Street 1:2127 VISTADALE CT
Mailing Address - Street 2:
Mailing Address - City:TUCKER
Mailing Address - State:GA
Mailing Address - Zip Code:30084-5418
Mailing Address - Country:US
Mailing Address - Phone:770-938-1776
Mailing Address - Fax:
Practice Address - Street 1:2127 VISTADALE CT
Practice Address - Street 2:
Practice Address - City:TUCKER
Practice Address - State:GA
Practice Address - Zip Code:30084-5418
Practice Address - Country:US
Practice Address - Phone:770-938-1776
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA0010931041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical