Monica Willis, LCSW, ED.D.

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

CSW004591 Issued in GA

Practice address

1211 Sherwood Park Dr NE Ste B
Gainesville, GA 30501-3444

Phone

(770) 219-9179

NPI assigned

Dec 17, 2010

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other names 1

• Monica Pope Former name

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1292544000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1613433600000",
    "number": "1023311875",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 742616",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303742616",
            "telephone_number": "770-219-8420"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1211 SHERWOOD PARK DR NE STE B",
            "city": "GAINESVILLE",
            "state": "GA",
            "postal_code": "305013444",
            "telephone_number": "770-219-9179"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3650 Steve Reynolds Boulevard",
            "address_2": "Kaiser Permanente Gwinnett Medical Center",
            "address_purpose": "LOCATION",
            "city": "Duluth",
            "state": "GA",
            "postal_code": "30096",
            "country_code": "US",
            "telephone_number": "770-931-6012",
            "fax_number": "770-356-4302",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WILLIS",
        "first_name": "MONICA",
        "name_prefix": "Dr.",
        "credential": "LCSW, ED.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-12-17",
        "last_updated": "2021-02-16",
        "certification_date": "2021-02-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "GA",
            "license": "BL-008203",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "GA",
            "license": "CSW004591",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "mpope107304@nghs.gadirect.net",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "1211 Sherwood Park Dr NE Ste B",
            "city": "Gainesville",
            "state": "GA",
            "country_code": "US",
            "postal_code": "305013444",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "MONICA",
            "last_name": "POPE",
            "credential": "LCSW, ED.D.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Paul Williams, MD
• Pete D Williams, MD
• Shaquanus Williams, LCSW
• Andrea Williamson-English
• Delbert Williamson, DDS
• Abigail Wilson
• Angela Renee Wilson
• Haley B. Wilson, PA-C
• Jeffrey Scott Wilson, LPC
• Samantha Castillo Wilson, PA-C

• Clinical Social Worker in Gainesville, GA
• Providers in Gainesville, 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 Feb 16, 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.