Provider Demographics
NPI:1699223594
Name:WOFSY, AVI HELEN (PMHNP)
Entity Type:Individual
Prefix:
First Name:AVI
Middle Name:HELEN
Last Name:WOFSY
Suffix:
Gender:F
Credentials:PMHNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:226 MADISON AVE
Mailing Address - Street 2:
Mailing Address - City:DECATUR
Mailing Address - State:GA
Mailing Address - Zip Code:30030-3542
Mailing Address - Country:US
Mailing Address - Phone:925-200-6191
Mailing Address - Fax:
Practice Address - Street 1:3520 PIEDMONT RD NE STE 330
Practice Address - Street 2:
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30305-1552
Practice Address - Country:US
Practice Address - Phone:404-351-2008
Practice Address - Fax:404-351-0243
Is Sole Proprietor?:No
Enumeration Date:2016-09-20
Last Update Date:2023-09-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN289555363LP0808X
CA95008206363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health