Active NPI
Sandra J Wimbush, LCSW
- Clinical Social Worker
- Griffin, GA
National Provider Identifier
1003668385
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- CSW005699
- Practice address
- 212 Hammerhawk Rd
Griffin, GA 30223-1515 - Phone
- (404) 444-0615
- NPI assigned
- Apr 2, 2024
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | CSW005699 | GA | Primary |
Addresses
Primary practice location
212 Hammerhawk Rd
Griffin, GA 30223-1515
Mailing address
PO Box 822
Griffin, GA 30224-0022
Phone (404) 444-0615
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: No
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1712016000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1712016000000",
"number": "1003668385",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 822",
"city": "GRIFFIN",
"state": "GA",
"postal_code": "302240022",
"telephone_number": "404-444-0615"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "212 HAMMERHAWK RD",
"city": "GRIFFIN",
"state": "GA",
"postal_code": "302231515",
"telephone_number": "404-444-0615"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WIMBUSH",
"first_name": "SANDRA",
"middle_name": "J",
"credential": "LCSW",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2024-04-02",
"last_updated": "2024-04-02",
"certification_date": "2024-04-02",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "GA",
"license": "CSW005699",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Griffin, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 2, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.