Provider Demographics
NPI:1679743629
Name:REAVES, CHARLOTTE ANNE (LCSW)
Entity Type:Individual
Prefix:MS
First Name:CHARLOTTE
Middle Name:ANNE
Last Name:REAVES
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 1:4565 SETTLES BRIDGE RD
Mailing Address - Street 2:
Mailing Address - City:SUWANEE
Mailing Address - State:GA
Mailing Address - Zip Code:30024-1983
Mailing Address - Country:US
Mailing Address - Phone:770-241-9797
Mailing Address - Fax:770-622-0773
Practice Address - Street 1:4565 SETTLES BRIDGE RD
Practice Address - Street 2:
Practice Address - City:SUWANEE
Practice Address - State:GA
Practice Address - Zip Code:30024-1983
Practice Address - Country:US
Practice Address - Phone:770-241-9797
Practice Address - Fax:770-622-0773
Is Sole Proprietor?:No
Enumeration Date:2008-03-06
Last Update Date:2008-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GACSW-0036791041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical