Provider Demographics
NPI:1861179152
Name:SCHULGASSERR, BETH LISA (LMSW)
Entity type:Individual
Prefix:
First Name:BETH
Middle Name:LISA
Last Name:SCHULGASSERR
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:BRACHA
Other - Middle Name:
Other - Last Name:SCHULGASSER
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:
Mailing Address - Street 1:4549 CHAMBLEE DUNWOODY RD
Mailing Address - Street 2:
Mailing Address - City:DUNWOODY
Mailing Address - State:GA
Mailing Address - Zip Code:30338-6210
Mailing Address - Country:US
Mailing Address - Phone:770-677-9300
Mailing Address - Fax:
Practice Address - Street 1:4549 CHAMBLEE DUNWOODY RD
Practice Address - Street 2:
Practice Address - City:DUNWOODY
Practice Address - State:GA
Practice Address - Zip Code:30338-6210
Practice Address - Country:US
Practice Address - Phone:770-677-9300
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-06-29
Last Update Date:2023-06-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAMSW010830104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker