Provider Demographics
NPI:1588790752
Name:NATION, ROSALIND J (PSYD, MSW, LCSW)
Entity type:Individual
Prefix:DR
First Name:ROSALIND
Middle Name:J
Last Name:NATION
Suffix:
Gender:F
Credentials:PSYD, MSW, 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 SE
Mailing Address - Street 2:SUITE 103
Mailing Address - City:SMYRNA
Mailing Address - State:GA
Mailing Address - Zip Code:30080-5306
Mailing Address - Country:US
Mailing Address - Phone:770-333-8960
Mailing Address - Fax:404-373-4241
Practice Address - Street 1:1260 CONCORD RD SE
Practice Address - Street 2:SUITE 103
Practice Address - City:SMYRNA
Practice Address - State:GA
Practice Address - Zip Code:30080-5306
Practice Address - Country:US
Practice Address - Phone:770-333-8960
Practice Address - Fax:404-373-4241
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-24
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA2051041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA11404292Medicare UPIN
GA80BBCDGMedicare ID - Type Unspecified