Individual provider Active NPI

Morrondo Edwards-Roberts, LISW-S, LICDC-CS

  • Clinical Social Worker
  • Atlanta, GA
National Provider Identifier
1023478609
Registry record updated Jul 30, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
CSW006960 Issued in GA
Practice address
735 Piedmont Ave NE
Atlanta, GA 30308-1416
Phone
(404) 588-4680
NPI assigned
Feb 25, 2016
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 30, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X I.1302419 OH
Clinical Social Worker 1041C0700X CSW006960 GA Primary

Addresses

Primary practice location

735 Piedmont Ave NE
Atlanta, GA 30308-1416

Mailing address

6255 W Sunset Blvd FL 21
Los Angeles, CA 90028-7422
Phone (323) 860-5200

Other practice location 1

815 W Broad St Ste 350
Columbus, OH 43222-1464
Phone (614) 223-1532

Other identifiers 1

IdentifierTypeStateIssuer
0160966MedicaidOH

Other names 1

  • Morrondo Edwards-Roberts Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH, GA, NY3 enrollments
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 3

Enrollment IDStateProvider typePAC IDDetails
I20160608001434 OH Practitioner - Clinical Social Worker 2264722925 Reassigns benefits to 4 organizations
I20200518002416 GA Practitioner - Clinical Social Worker 2264722925 Reassigns benefits to 3 organizations
I20250806004252 NY Practitioner - Clinical Social Worker 2264722925 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
CSW006960GAMDClinical Social Worker
I.1302419OHMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
On the Level Counseling Therapy & Training LLC Clinical CurrentSince Jul 13, 2020 Accepting new patients
Signature Health Inc CurrentSince Sep 30, 2019 Accepting new patients
Grow Healthcare Group PA Clinical CurrentSince Jul 23, 2024 Accepting new patients
Signature Health, Inc. CurrentSince Sep 30, 2019 Accepting new patients
AIDS Healthcare Foundation CurrentSince Jun 1, 2024 Accepting new patients
AIDS Healthcare Foundation CurrentSince Jun 1, 2024 Accepting new patients
AIDS Healthcare Foundation Current Accepting new patients
AIDS Healthcare Foundation CurrentSince Jun 1, 2024 Accepting new patients

Locations

6255 W Sunset Blvd
Fl 21
Los Angeles, CA 90028
Phone (323) 860-5200

66 W Flagler St
Ste 900
Miami, FL 33130
Phone (786) 244-7711

1438 W Peachtree St NW
Atlanta, GA 30309
Phone (470) 283-7349

715 Peachtree St NE
Ste 100
Atlanta, GA 30308
Phone (202) 972-4964

735 Piedmont Ave NE
Atlanta, GA 30308
Phone (404) 588-4680

5700 Hillandale Dr
Ste 100
Lithonia, GA 30058
Phone (770) 593-6684

165 Broadway
Fl 23
New York, NY 10006
Phone (202) 972-4964

2829 Euclid Ave
Cleveland, OH 44115
Phone (216) 357-3131

4449 Easton Way
Fl 2
Columbus, OH 43219
Phone (614) 565-8197

815 W Broad St
Ste 350
Columbus, OH 43222
Phone (614) 223-1532

21100 Southgate Park Blvd
Maple Heights, OH 44137
Phone (216) 663-6100

7232 Justin Way
Mentor, OH 44060
Phone (440) 488-2855

38882 Mentor Ave
Willoughby, OH 44094

38876 Mentor Ave
Willoughby, OH 44094
Phone (440) 954-3333

Organizations & group practices 8

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": "1456358400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1722297600000",
    "number": "1023478609",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6255 W SUNSET BLVD FL 21",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900287422",
            "telephone_number": "323-860-5200",
            "fax_number": "323-467-7119"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "735 PIEDMONT AVE NE",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303081416",
            "telephone_number": "404-588-4680"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "815 W Broad St Ste 350",
            "address_purpose": "LOCATION",
            "city": "Columbus",
            "state": "OH",
            "postal_code": "432221464",
            "country_code": "US",
            "telephone_number": "614-223-1532",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "EDWARDS-ROBERTS",
        "first_name": "MORRONDO",
        "credential": "LISW-S, LICDC-CS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-02-25",
        "last_updated": "2024-07-30",
        "certification_date": "2021-09-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "OH",
            "license": "I.1302419",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "GA",
            "license": "CSW006960",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0160966",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MORRONDO",
            "last_name": "EDWARDS-ROBERTS",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Atlanta, GA

Sources for this page

Verify at the official NPI Registry.