Provider Demographics
NPI:1538241138
Name:PLECKO, JUDITH MARTIN (LCSW)
Entity type:Individual
Prefix:MS
First Name:JUDITH
Middle Name:MARTIN
Last Name:PLECKO
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:5611 BOSTWICK CT
Mailing Address - Street 2:
Mailing Address - City:NORCROSS
Mailing Address - State:GA
Mailing Address - Zip Code:30092-2000
Mailing Address - Country:US
Mailing Address - Phone:404-312-4926
Mailing Address - Fax:770-248-0810
Practice Address - Street 1:1700 TREE LN
Practice Address - Street 2:SUITE 260
Practice Address - City:SNELLVILLE
Practice Address - State:GA
Practice Address - Zip Code:30078-6782
Practice Address - Country:US
Practice Address - Phone:770-736-7534
Practice Address - Fax:770-736-8627
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
GA0006411041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical