Provider Demographics
NPI:1861526584
Name:FROST, JAMES BRANCH (MSW)
Entity type:Individual
Prefix:MR
First Name:JAMES
Middle Name:BRANCH
Last Name:FROST
Suffix:
Gender:M
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2996 GRANDVIEW AVE NE
Mailing Address - Street 2:SUITE 208 ROBERTS BUILDING
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30305
Mailing Address - Country:US
Mailing Address - Phone:404-237-1917
Mailing Address - Fax:770-587-0463
Practice Address - Street 1:2996 GRANDVIEW AVE NE
Practice Address - Street 2:SUITE 208 ROBERTS BUILDING
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30305
Practice Address - Country:US
Practice Address - Phone:404-237-1917
Practice Address - Fax:770-587-0463
Is Sole Proprietor?:No
Enumeration Date:2007-03-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GALCSW 0001471041C0700X
GALMFT 000297106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Not Answered106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist