Individual provider Active NPI

Bonita Jo Klopach, LCSW

  • Clinical Social Worker
  • Marietta, GA
National Provider Identifier
1003303231
Registry record updated Jun 18, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
CSW007150 Issued in GA
Practice address
4343 Shallowford Rd Ste C-1
Marietta, GA 30062-5023
Phone
(678) 740-3757
Fax
(770) 993-9800
NPI assigned
Apr 13, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 18, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X CSW007150 GA Primary

Addresses

Primary practice location

4343 Shallowford Rd Ste C-1
Marietta, GA 30062-5023

Mailing address

4343 Shallowford Rd Ste 410
Marietta, GA 30062-5067
Phone (678) 384-4911

Other practice location 1

4595 Towne Lake Pkwy Ste 250
Woodstock, GA 30189-5514
Phone (678) 740-3757

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20241108000544 GA Practitioner - Clinical Social Worker 9335577527 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Privia Medical Group of Georgia LLCGroup PAC ID 4284951542, 454 clinicians

Practice addresses (Care Compare)

101 Yorktown Dr
Fayetteville, GA 30214-1578

3235 S Cherokee Lane
BLDG 1200
Woodstock, GA 30188-7026
Phone (678) 384-4911

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
MSW006828GAMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Privia Medical Group of Georgia LLC CurrentSince Jul 28, 2024 Accepting new patients
Privia Medical Group of Georgia LLC CurrentSince Jul 28, 2024 Accepting new patients

Locations

3715 Northside Pkwy NW
Bldg 100
Atlanta, GA 30327
Phone (404) 262-7414

101 Yorktown Dr
Ste 100
Fayetteville, GA 30214
Phone (770) 460-4285

4343 Shallowford Rd
Ste 410
Marietta, GA 30062
Phone (678) 384-4911

3217 S Cherokee Ln
Ste 730
Woodstock, GA 30188
Phone (678) 384-4911

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/8042/brand/1/csg/1/fhir/r4
  • Direct secure messaging: bonita.klopach.1@8042.direct.athenahealth.com

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1523577600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1781740800000",
    "number": "1003303231",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4343 SHALLOWFORD RD STE 410",
            "city": "MARIETTA",
            "state": "GA",
            "postal_code": "300625067",
            "telephone_number": "678-384-4911",
            "fax_number": "678-405-3259"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4343 SHALLOWFORD RD STE C-1",
            "city": "MARIETTA",
            "state": "GA",
            "postal_code": "300625023",
            "telephone_number": "678-740-3757",
            "fax_number": "770-993-9800"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4595 Towne Lake Pkwy Ste 250",
            "address_purpose": "LOCATION",
            "city": "Woodstock",
            "state": "GA",
            "postal_code": "301895514",
            "country_code": "US",
            "telephone_number": "678-740-3757",
            "fax_number": "770-993-9800",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KLOPACH",
        "first_name": "BONITA",
        "middle_name": "JO",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-04-13",
        "last_updated": "2026-06-18",
        "certification_date": "2026-06-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "GA",
            "license": "CSW007150",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Marietta, GA

Sources for this page

Verify at the official NPI Registry.