Provider Demographics
NPI:1811790702
Name:HEWELL, MARY L (CAADC)
Entity type:Individual
Prefix:
First Name:MARY
Middle Name:L
Last Name:HEWELL
Suffix:
Gender:F
Credentials:CAADC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:4011 JOE CHANDLER RD
Mailing Address - Street 2:
Mailing Address - City:GILLSVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30543-2302
Mailing Address - Country:US
Mailing Address - Phone:770-539-2118
Mailing Address - Fax:
Practice Address - Street 1:592 MEDICAL PARK DR STE A
Practice Address - Street 2:
Practice Address - City:GAINESVILLE
Practice Address - State:GA
Practice Address - Zip Code:30501-2055
Practice Address - Country:US
Practice Address - Phone:770-503-7721
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-03-28
Last Update Date:2025-03-28
Deactivation Date:
Deactivation Code:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)