Provider Demographics
NPI:1144300591
Name:GALYEAN, SALLIE ANN (LCSW)
Entity type:Individual
Prefix:MRS
First Name:SALLIE
Middle Name:ANN
Last Name:GALYEAN
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:MISS
Other - First Name:SALLIE
Other - Middle Name:ANN
Other - Last Name:HORN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:4499 GA HIGHWAY 40 E STE A
Mailing Address - Street 2:
Mailing Address - City:SAINT MARYS
Mailing Address - State:GA
Mailing Address - Zip Code:31558-9402
Mailing Address - Country:US
Mailing Address - Phone:912-674-1130
Mailing Address - Fax:912-729-4626
Practice Address - Street 1:4499 GA HIGHWAY 40 E STE A
Practice Address - Street 2:
Practice Address - City:SAINT MARYS
Practice Address - State:GA
Practice Address - Zip Code:31558-9402
Practice Address - Country:US
Practice Address - Phone:912-674-1130
Practice Address - Fax:912-729-4626
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-17
Last Update Date:2019-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GACSW0036931041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical