Provider Demographics
NPI:1891425047
Name:JOINER-WOODARD, ELLEN C (LCSW)
Entity Type:Individual
Prefix:
First Name:ELLEN
Middle Name:C
Last Name:JOINER-WOODARD
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:ELLEN
Other - Middle Name:C
Other - Last Name:WOODARD
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:LCSW
Mailing Address - Street 1:8655 MORVEN RD
Mailing Address - Street 2:
Mailing Address - City:HAHIRA
Mailing Address - State:GA
Mailing Address - Zip Code:31632-2277
Mailing Address - Country:US
Mailing Address - Phone:229-563-6754
Mailing Address - Fax:
Practice Address - Street 1:8655 MORVEN RD
Practice Address - Street 2:
Practice Address - City:HAHIRA
Practice Address - State:GA
Practice Address - Zip Code:31632-2277
Practice Address - Country:US
Practice Address - Phone:229-563-6754
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-06-12
Last Update Date:2022-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GACSW0031581041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical