Provider Demographics
NPI:1598205114
Name:RYMER, SHEENA GADDIS (LMSW)
Entity type:Individual
Prefix:MRS
First Name:SHEENA
Middle Name:GADDIS
Last Name:RYMER
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:168 ROGERS ST
Mailing Address - Street 2:SUITE 103
Mailing Address - City:BLAIRSVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30512-3693
Mailing Address - Country:US
Mailing Address - Phone:770-500-0681
Mailing Address - Fax:844-876-6931
Practice Address - Street 1:168 ROGERS ST
Practice Address - Street 2:SUITE 103
Practice Address - City:BLAIRSVILLE
Practice Address - State:GA
Practice Address - Zip Code:30512-3693
Practice Address - Country:US
Practice Address - Phone:770-500-0681
Practice Address - Fax:844-876-6931
Is Sole Proprietor?:No
Enumeration Date:2017-03-01
Last Update Date:2017-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAMSW006895104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker