Provider Demographics
NPI:1699727396
Name:LASHER, SUSAN (MSW, LCSW, LMFT)
Entity type:Individual
Prefix:
First Name:SUSAN
Middle Name:
Last Name:LASHER
Suffix:
Gender:F
Credentials:MSW, LCSW, LMFT
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 105
Mailing Address - City:SMYRNA
Mailing Address - State:GA
Mailing Address - Zip Code:30080-5306
Mailing Address - Country:US
Mailing Address - Phone:770-434-2531
Mailing Address - Fax:
Practice Address - Street 1:1260 CONCORD RD SE
Practice Address - Street 2:SUITE 105
Practice Address - City:SMYRNA
Practice Address - State:GA
Practice Address - Zip Code:30080-5306
Practice Address - Country:US
Practice Address - Phone:770-434-2531
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-17
Last Update Date:2020-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA7951041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA781874298AMedicaid
GA781874298BMedicaid