Provider Demographics
NPI:1770289605
Name:ASHONG, MARY CURTIS (LCSW)
Entity type:Individual
Prefix:MRS
First Name:MARY
Middle Name:CURTIS
Last Name:ASHONG
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 1:4340 ANTELOPE LANE
Mailing Address - Street 2:
Mailing Address - City:SNELLVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30039
Mailing Address - Country:US
Mailing Address - Phone:404-610-8162
Mailing Address - Fax:
Practice Address - Street 1:4340 ANTELOPE LANE
Practice Address - Street 2:
Practice Address - City:SNELLVILLE
Practice Address - State:GA
Practice Address - Zip Code:30039
Practice Address - Country:US
Practice Address - Phone:404-610-8162
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-02-02
Last Update Date:2023-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GACSW0009051041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty