Provider Demographics
NPI:1750979209
Name:MCKERROW, GINAIR GOODWIN (LCSW)
Entity type:Individual
Prefix:
First Name:GINAIR
Middle Name:GOODWIN
Last Name:MCKERROW
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:GINAIR
Other - Middle Name:
Other - Last Name:GOODWIN-MCKERROW
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:
Mailing Address - Street 1:6100 LAKE FORREST DR STE 450
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30328-3837
Mailing Address - Country:US
Mailing Address - Phone:404-983-3320
Mailing Address - Fax:404-549-9316
Practice Address - Street 1:6100 LAKE FORREST DR STE 450
Practice Address - Street 2:
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30328-3837
Practice Address - Country:US
Practice Address - Phone:404-983-3320
Practice Address - Fax:404-549-9316
Is Sole Proprietor?:Yes
Enumeration Date:2021-01-08
Last Update Date:2021-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GACSW0041861041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical