Provider Demographics
NPI:1881600096
Name:WOODS, LILLIAN ANN (MSW)
Entity type:Individual
Prefix:MS
First Name:LILLIAN
Middle Name:ANN
Last Name:WOODS
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:2826 KNOLLBERRY LN
Mailing Address - Street 2:
Mailing Address - City:DECATUR
Mailing Address - State:GA
Mailing Address - Zip Code:30034-3205
Mailing Address - Country:US
Mailing Address - Phone:404-321-6111
Mailing Address - Fax:404-728-7779
Practice Address - Street 1:VA MEDICAL CENTER
Practice Address - Street 2:1670 CLAIRMONT ROAD
Practice Address - City:DECATUR
Practice Address - State:GA
Practice Address - Zip Code:30033-0000
Practice Address - Country:US
Practice Address - Phone:404-321-6111
Practice Address - Fax:404-728-7779
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-31
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GACSW0002571041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
GACSW000257OtherSOCIAL WORK LICENSE