Provider Demographics
NPI:1720555816
Name:SKOLLAR, MILENA GARCIA (LCSW)
Entity Type:Individual
Prefix:
First Name:MILENA
Middle Name:GARCIA
Last Name:SKOLLAR
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 1:6100 LAKE FORREST DR
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30328-3822
Mailing Address - Country:US
Mailing Address - Phone:404-219-4828
Mailing Address - Fax:
Practice Address - Street 1:6100 LAKE FORREST DR
Practice Address - Street 2:
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30328-3822
Practice Address - Country:US
Practice Address - Phone:404-219-4828
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-10-27
Last Update Date:2018-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GACSW0028571041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical