Iriss Mickens, LMSW
Counselor in Decatur, GA. Individual provider (NPI-1).
NPI number1124861604
StatusActive
Last updated in NPPESJun 13, 2024
Details
- NPI
- 1124861604
- Entity type
- Individual (NPI-1)
- Name
- Iriss Mickens
- Credential
- LMSW
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- Jun 13, 2024
- Certification date
- Jun 13, 2024
- Last updated
- Jun 13, 2024
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 101Y00000X | Counselor | MSW009542 | GA | Yes |
Practice location
455 Winn WayDecatur, GA 30030-1707
Phone 404-508-6430
Mailing address
445 Winn WayDecatur, GA 30030-1707
Phone 404-294-3835
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