Provider Demographics
NPI:1871830372
Name:BARRON, ELAINE BRYANT (MASTER SOCIAL WORKER)
Entity Type:Individual
Prefix:MS
First Name:ELAINE
Middle Name:BRYANT
Last Name:BARRON
Suffix:
Gender:F
Credentials:MASTER SOCIAL WORKER
Other - Prefix:MS
Other - First Name:MARGARET
Other - Middle Name:ELAINE
Other - Last Name:BRYANT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN
Mailing Address - Street 1:530 HIGHLANDS OVERLOOK
Mailing Address - Street 2:
Mailing Address - City:ROSWELL
Mailing Address - State:GA
Mailing Address - Zip Code:30075-4756
Mailing Address - Country:US
Mailing Address - Phone:770-262-1281
Mailing Address - Fax:
Practice Address - Street 1:580 W CROSSVILLE RD STE 201
Practice Address - Street 2:
Practice Address - City:ROSWELL
Practice Address - State:GA
Practice Address - Zip Code:30075-7511
Practice Address - Country:US
Practice Address - Phone:770-643-4877
Practice Address - Fax:770-643-4854
Is Sole Proprietor?:Yes
Enumeration Date:2013-01-03
Last Update Date:2013-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAMSW0055431041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical