Individual provider · Type 1 NPI

Mary Stack, LCSW

Clinical Social Worker · Peachtree Corners, GA

NPI number 1144757659 Active

Practice location

6624 Jimmy Carter Blvd Ste A
Peachtree Corners, GA 30071-1727

Call (770) 743-0004 Map

Fax (404) 900-5453

Mailing address

3497 Tulip Tree Ln
Duluth, GA 30096-5332

Specialties and licenses

TaxonomyCodeLicense
Clinical Social Worker Primary 1041C0700XCSW004583

Clinical Social Worker: A social worker who holds a master's or doctoral degree in social work from an accredited school of social work in addition to at least two years of post-master's supervised experience in a clinical setting. The social worker must be licensed, certified, or registered at the clinical level in the jurisdiction of practice. A clinical social worker provides direct services, including interventions focused on interpers…

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About NPI 1144757659

Mary Stack, LCSW's National Provider Identifier is 1144757659, issued on May 15, 2017. The primary taxonomy on file is Clinical Social Worker (1041C0700X), and the practice location is in Peachtree Corners, GA. The record was last updated on May 15, 2017.