Provider Demographics
NPI:1699212910
Name:AUSTIN, TAMMY (LCSW)
Entity Type:Individual
Prefix:
First Name:TAMMY
Middle Name:
Last Name:AUSTIN
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 1:100 POSTMASTER DR
Mailing Address - Street 2:2631
Mailing Address - City:MCDONOUGH
Mailing Address - State:GA
Mailing Address - Zip Code:30253-2838
Mailing Address - Country:US
Mailing Address - Phone:678-200-9044
Mailing Address - Fax:
Practice Address - Street 1:4343 WARM SPRINGS RD
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:GA
Practice Address - Zip Code:31909-5902
Practice Address - Country:US
Practice Address - Phone:404-667-5942
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-01-24
Last Update Date:2023-10-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CSW0059881041C0700X
GACSW0059881041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical