Provider Demographics
NPI:1104516236
Name:ADAMS TELFAIR, MATTIE ELIZABETH (LMSW)
Entity type:Individual
Prefix:MS
First Name:MATTIE
Middle Name:ELIZABETH
Last Name:ADAMS TELFAIR
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:4163 GREEN FIELD DR
Mailing Address - Street 2:
Mailing Address - City:DOUGLASVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30135-8310
Mailing Address - Country:US
Mailing Address - Phone:404-859-7529
Mailing Address - Fax:
Practice Address - Street 1:1701 HARDEE AVE SW
Practice Address - Street 2:
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30310-5110
Practice Address - Country:US
Practice Address - Phone:404-230-5683
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-05-11
Last Update Date:2023-05-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker