Provider Demographics
NPI:1629227418
Name:MAGILL, WILLIAM H (LCSW)
Entity Type:Individual
Prefix:MR
First Name:WILLIAM
Middle Name:H
Last Name:MAGILL
Suffix:
Gender:M
Credentials:LCSW
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 191183
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:31119-1183
Mailing Address - Country:US
Mailing Address - Phone:404-219-2412
Mailing Address - Fax:404-321-9888
Practice Address - Street 1:2801 BUFORD HWY NE
Practice Address - Street 2:SUITE T-60
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30329-2149
Practice Address - Country:US
Practice Address - Phone:404-219-2412
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-09-16
Last Update Date:2008-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GACSW0034521041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
GACSW003452OtherLICENSED CLINICAL SOCIAL WORKER