Provider Demographics
NPI:1952529943
Name:GILBERT, JANETTE BLACK (LCSW)
Entity Type:Individual
Prefix:MRS
First Name:JANETTE
Middle Name:BLACK
Last Name:GILBERT
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 1:1260 CONCORD RD
Mailing Address - Street 2:SUITE 204
Mailing Address - City:SMYRNA
Mailing Address - State:GA
Mailing Address - Zip Code:30080
Mailing Address - Country:US
Mailing Address - Phone:770-333-0045
Mailing Address - Fax:404-256-5969
Practice Address - Street 1:1260 CONCORD RD
Practice Address - Street 2:SUITE 204
Practice Address - City:SMYRNA
Practice Address - State:GA
Practice Address - Zip Code:30080
Practice Address - Country:US
Practice Address - Phone:770-333-0045
Practice Address - Fax:404-256-5969
Is Sole Proprietor?:No
Enumeration Date:2007-04-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA11381041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical