Provider Demographics
NPI:1841439924
Name:PRATT, E DOUGLAS (LCSW)
Entity type:Individual
Prefix:DR
First Name:E
Middle Name:DOUGLAS
Last Name:PRATT
Suffix:
Gender:M
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3162 JOHNSON FERRY ROAD
Mailing Address - Street 2:SUITE 260-426
Mailing Address - City:MARIETTA
Mailing Address - State:GA
Mailing Address - Zip Code:30062
Mailing Address - Country:US
Mailing Address - Phone:770-714-9105
Mailing Address - Fax:
Practice Address - Street 1:3162 JOHNSON FERRY RD
Practice Address - Street 2:SUITE 260-426
Practice Address - City:MARIETTA
Practice Address - State:GA
Practice Address - Zip Code:30062-7604
Practice Address - Country:US
Practice Address - Phone:770-714-9105
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-02-12
Last Update Date:2014-02-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GACSW0011921041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical