Provider Demographics
NPI:1588983712
Name:VANZANT, CARRIE P (LCSW)
Entity type:Individual
Prefix:
First Name:CARRIE
Middle Name:P
Last Name:VANZANT
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 1:1534 N COLUMBIA PL
Mailing Address - Street 2:
Mailing Address - City:DECATUR
Mailing Address - State:GA
Mailing Address - Zip Code:30032-4619
Mailing Address - Country:US
Mailing Address - Phone:404-284-2707
Mailing Address - Fax:
Practice Address - Street 1:1534 N COLUMBIA PL
Practice Address - Street 2:
Practice Address - City:DECATUR
Practice Address - State:GA
Practice Address - Zip Code:30032-4619
Practice Address - Country:US
Practice Address - Phone:770-363-4294
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-05-27
Last Update Date:2011-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker