Provider Demographics
NPI:1760018550
Name:PEW, IMAN PEARLINE (LCSW)
Entity Type:Individual
Prefix:
First Name:IMAN
Middle Name:PEARLINE
Last Name:PEW
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 1:766 COOPER ST SW
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30315-1038
Mailing Address - Country:US
Mailing Address - Phone:205-821-7684
Mailing Address - Fax:
Practice Address - Street 1:766 COOPER ST SW
Practice Address - Street 2:
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30315-1038
Practice Address - Country:US
Practice Address - Phone:205-821-7684
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-03-12
Last Update Date:2022-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker