Opal Hope Minott, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

CSW003893 Issued in GA

Practice address

1083 Simonton Hill CT
Lawrenceville, GA 30045-3531

Phone

(770) 375-0479

Fax

(678) 985-4228

NPI assigned

Jan 22, 2008

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Institute for Community Living , Inc.

  • Community/Behavioral Health Agency
  • Brooklyn, NY
  • NPI 1558494930
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1200960000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1636675200000",
    "number": "1003093030",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1083 SIMONTON HILL CT",
            "city": "LAWRENCEVILLE",
            "state": "GA",
            "postal_code": "300453531",
            "telephone_number": "770-375-0479",
            "fax_number": "678-985-4228"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1083 SIMONTON HILL CT",
            "city": "LAWRENCEVILLE",
            "state": "GA",
            "postal_code": "300453531",
            "telephone_number": "770-375-0479",
            "fax_number": "678-985-4228"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MINOTT",
        "first_name": "OPAL",
        "middle_name": "HOPE",
        "name_prefix": "Miss",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-01-22",
        "last_updated": "2021-11-12",
        "certification_date": "2021-11-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "GA",
            "license": "CSW003893",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "286447905A",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Mind Haven LLC
• Mindful Faith Psychiatry Care LLC
• Minding My Health Solutions LLC
• Carolyn M Minor, LCSW
• Makeda Minott
• Mira Chiropractic Clinic, LLC
• Kenyatta Mireku, MD
• Mirror Image Group, LLC
• Mission Point Hospice LLC
• Hunaiza Mistry, NP

• Clinical Social Worker in Lawrenceville, GA
• Providers in Lawrenceville, GA by specialty
• Clinical Social Worker in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 12, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.