Provider Demographics
NPI:1902085830
Name:YOUNGBLOOD, HEATHER VOELKEL (MSW, LCSW)
Entity Type:Individual
Prefix:
First Name:HEATHER
Middle Name:VOELKEL
Last Name:YOUNGBLOOD
Suffix:
Gender:F
Credentials:MSW, LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3951 CHAPEL GROVE DR
Mailing Address - Street 2:
Mailing Address - City:MARIETTA
Mailing Address - State:GA
Mailing Address - Zip Code:30062-1067
Mailing Address - Country:US
Mailing Address - Phone:678-777-8744
Mailing Address - Fax:
Practice Address - Street 1:455 E PACES FERRY RD NE
Practice Address - Street 2:SUITE 203
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30305-3313
Practice Address - Country:US
Practice Address - Phone:678-777-8744
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-10-27
Last Update Date:2007-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA27301041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical