Provider Demographics
NPI:1811650575
Name:PAUL, ANDREA MARIE (LCSW)
Entity type:Individual
Prefix:
First Name:ANDREA
Middle Name:MARIE
Last Name:PAUL
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:ANDREA
Other - Middle Name:MARIE
Other - Last Name:ATKINSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2150 LIMESTONE PKWY STE 222
Mailing Address - Street 2:
Mailing Address - City:GAINESVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30501-2567
Mailing Address - Country:US
Mailing Address - Phone:770-219-8888
Mailing Address - Fax:
Practice Address - Street 1:2150 LIMESTONE PKWY STE 222
Practice Address - Street 2:
Practice Address - City:GAINESVILLE
Practice Address - State:GA
Practice Address - Zip Code:30501-2567
Practice Address - Country:US
Practice Address - Phone:770-219-8888
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-10-20
Last Update Date:2022-01-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GACSW0068581041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical