Provider Demographics
NPI:1386386449
Name:ASARE, GLORIA OKAEWA (LCSW)
Entity type:Individual
Prefix:
First Name:GLORIA
Middle Name:OKAEWA
Last Name:ASARE
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 1:3605 SANDY PLAINS RD STE 493
Mailing Address - Street 2:
Mailing Address - City:MARIETTA
Mailing Address - State:GA
Mailing Address - Zip Code:30066-3068
Mailing Address - Country:US
Mailing Address - Phone:703-887-5053
Mailing Address - Fax:
Practice Address - Street 1:3605 SANDY PLAINS RD STE 493
Practice Address - Street 2:
Practice Address - City:MARIETTA
Practice Address - State:GA
Practice Address - Zip Code:30066-3068
Practice Address - Country:US
Practice Address - Phone:703-887-5053
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-04-10
Last Update Date:2022-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GACSW0079921041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty