Provider Demographics
NPI:1629439393
Name:NOLAN, MARIBETH (LCSW)
Entity Type:Individual
Prefix:
First Name:MARIBETH
Middle Name:
Last Name:NOLAN
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:355 MEADOWOOD DR
Mailing Address - Street 2:
Mailing Address - City:ROSWELL
Mailing Address - State:GA
Mailing Address - Zip Code:30075-4504
Mailing Address - Country:US
Mailing Address - Phone:770-315-4516
Mailing Address - Fax:
Practice Address - Street 1:355 MEADOWOOD DR
Practice Address - Street 2:
Practice Address - City:ROSWELL
Practice Address - State:GA
Practice Address - Zip Code:30075-4504
Practice Address - Country:US
Practice Address - Phone:770-315-4516
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-03-09
Last Update Date:2020-09-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical