Individual provider Active NPI

Marilyn Ashleigh Trudeau-Walls, LMSW

  • Social Worker
  • Atlanta, GA
National Provider Identifier
1003502428
Registry record updated Apr 18, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
License
MSW009533 Issued in GA
Practice address
2727 Paces Ferry Rd SE Ste 260
Atlanta, GA 30339-4053
Phone
(678) 758-0616
NPI assigned
Apr 18, 2023
Last updated
Apr 18, 2023By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 18, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X MSW009533 GA Primary

Addresses

Primary practice location

2727 Paces Ferry Rd SE Ste 260
Atlanta, GA 30339-4053

Mailing address

1103 Park BRG
Acworth, GA 30101-7212
Phone (678) 575-8384

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
MSW009533GAMDSocial Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Dr. Sean Michael Hirt, Inc CurrentSince Apr 23, 2023 Accepting new patients

Locations

2727 Paces Ferry Rd SE
Ste 260
Atlanta, GA 30339
Phone (678) 758-0616

Organizations & group practices 1

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

NPI Registry JSON

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

{
    "created_epoch": "1681776000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1681776000000",
    "number": "1003502428",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1103 PARK BRG",
            "city": "ACWORTH",
            "state": "GA",
            "postal_code": "301017212",
            "telephone_number": "678-575-8384"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2727 PACES FERRY RD SE STE 260",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303394053",
            "telephone_number": "678-758-0616"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TRUDEAU-WALLS",
        "first_name": "MARILYN",
        "middle_name": "ASHLEIGH",
        "credential": "LMSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-04-18",
        "last_updated": "2023-04-18",
        "certification_date": "2023-04-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "GA",
            "license": "MSW009533",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Atlanta, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 18, 2023; 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.