Provider Demographics
NPI:1942393962
Name:GARRETT, RICHARD FRANCIS (MSW)
Entity type:Individual
Prefix:MR
First Name:RICHARD
Middle Name:FRANCIS
Last Name:GARRETT
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 1:2925 LEDO RD STE 1
Mailing Address - Street 2:
Mailing Address - City:ALBANY
Mailing Address - State:GA
Mailing Address - Zip Code:31707-1267
Mailing Address - Country:US
Mailing Address - Phone:229-483-5050
Mailing Address - Fax:229-485-1103
Practice Address - Street 1:2925 LEDO RD
Practice Address - Street 2:
Practice Address - City:ALBANY
Practice Address - State:GA
Practice Address - Zip Code:31707-1266
Practice Address - Country:US
Practice Address - Phone:229-483-5050
Practice Address - Fax:706-545-1695
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-02
Last Update Date:2023-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA0012121041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA0031852268AMedicaid