Provider Demographics
NPI:1649474867
Name:AYLING, LORI JEANSONNE (LCSW)
Entity type:Individual
Prefix:MRS
First Name:LORI
Middle Name:JEANSONNE
Last Name:AYLING
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2040 EMERY PL NE
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30317-1221
Mailing Address - Country:US
Mailing Address - Phone:404-275-5034
Mailing Address - Fax:
Practice Address - Street 1:2040 EMERY PL NE
Practice Address - Street 2:
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30317-1221
Practice Address - Country:US
Practice Address - Phone:404-275-5034
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-06-12
Last Update Date:2015-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GACSW0036571041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical