Provider Demographics
NPI:1316519994
Name:ABRAHAM, RAZIYA (LCSW)
Entity type:Individual
Prefix:MS
First Name:RAZIYA
Middle Name:
Last Name:ABRAHAM
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:RAZI
Other - Middle Name:
Other - Last Name:ABRAHAM
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:LCSW
Mailing Address - Street 1:485 CHANDLER POND DR
Mailing Address - Street 2:
Mailing Address - City:LAWRENCEVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30043
Mailing Address - Country:US
Mailing Address - Phone:404-654-3313
Mailing Address - Fax:
Practice Address - Street 1:485 CHANDLER POND DR
Practice Address - Street 2:
Practice Address - City:LAWRENCEVILLE
Practice Address - State:GA
Practice Address - Zip Code:30043
Practice Address - Country:US
Practice Address - Phone:404-654-3313
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-07-13
Last Update Date:2021-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GACSW0074411041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical