Provider Demographics
NPI:1184783730
Name:YOUSSEF, GEORGIA BROWN (MA, LMFT)
Entity type:Individual
Prefix:MRS
First Name:GEORGIA
Middle Name:BROWN
Last Name:YOUSSEF
Suffix:
Gender:F
Credentials:MA, LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8025 N POINT BLVD
Mailing Address - Street 2:SUITE 231
Mailing Address - City:WINSTON SALEM
Mailing Address - State:NC
Mailing Address - Zip Code:27106-3262
Mailing Address - Country:US
Mailing Address - Phone:336-896-0065
Mailing Address - Fax:336-896-0710
Practice Address - Street 1:8025 N POINT BLVD
Practice Address - Street 2:SUITE 231
Practice Address - City:WINSTON SALEM
Practice Address - State:NC
Practice Address - Zip Code:27106-3262
Practice Address - Country:US
Practice Address - Phone:336-896-0065
Practice Address - Fax:336-896-0710
Is Sole Proprietor?:No
Enumeration Date:2006-12-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC606106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist