NPIMap

Organization Active NPI

Doreen Church LCSW LLC

  • Clinical Social Worker
  • Atlanta, GA
National Provider Identifier
1023543790
Registry record updated May 1, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
CSW006026 Issued in GA
Legal business name
DOREEN CHURCH LCSW LLC
Practice address
1663 Executive Park LN NE
Atlanta, GA 30329-3130
Phone
(678) 662-0029
NPI assigned
May 1, 2017
Last updated
May 1, 2017By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 1, 2017

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

Authorized official

Name
Doreen Church, LCSWNPI 1467985093
Title
Counselor
Phone
(678) 662-0029

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social WorkerGroup: 193400000X SINGLE SPECIALTY GROUP 1041C0700X CSW006026 GA Primary

Addresses

Primary practice location

1663 Executive Park LN NE
Atlanta, GA 30329-3130

Mailing address

1663 Executive Park LN NE
Atlanta, GA 30329-3130
Phone (678) 662-0029

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1493596800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1493596800000",
    "number": "1023543790",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1663 EXECUTIVE PARK LN NE",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303293130",
            "telephone_number": "678-662-0029"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1663 EXECUTIVE PARK LN NE",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303293130",
            "telephone_number": "678-662-0029"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DOREEN CHURCH LCSW LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-05-01",
        "last_updated": "2017-05-01",
        "status": "A",
        "authorized_official_last_name": "CHURCH",
        "authorized_official_first_name": "DOREEN",
        "authorized_official_title_or_position": "COUNSELOR",
        "authorized_official_telephone_number": "678-662-0029",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Social Worker, Clinical",
            "state": "GA",
            "license": "CSW006026",
            "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 May 1, 2017; 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.