Organization Active NPI

Marlene Belmont Sukiennik, LCSW, LLC

  • Clinical Social Worker
  • Atlanta, GA
National Provider Identifier
1033512686
Registry record updated Sep 26, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
CSW005178 Issued in GA
Legal business name
MARLENE BELMONT SUKIENNIK, LCSW, LLC
Practice address
245 W Wieuca Rd NE
Ste #140
Atlanta, GA 30342-3372
Phone
(678) 720-8921
NPI assigned
Sep 26, 2014
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 26, 2014

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

Authorized official

Name
Marlene SukiennikNPI 1588642649
Title
Licensed Clinical Social Worker
Phone
(678) 720-8921

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social WorkerGroup: 193400000X SINGLE SPECIALTY GROUP 1041C0700X CSW005178 GA Primary

Addresses

Primary practice location

245 W Wieuca Rd NE
Ste #140
Atlanta, GA 30342-3372

Mailing address

245 W Wieuca Rd NE
Ste #140
Atlanta, GA 30342-3372

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20150624001352 GA Part B Supplier - Clinic/Group Practice 0648581173 Receives reassigned benefits from 1 practitioner
Practice locations: Atlanta, GA

National Provider Directory

National Provider Directory

Locations

245 W Wieuca Rd NE
Ste 140
Atlanta, GA 30342
Phone (678) 720-8921

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1411689600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1411689600000",
    "number": "1033512686",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "245 W WIEUCA RD NE",
            "address_2": "STE #140",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303423372"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "245 W WIEUCA RD NE",
            "address_2": "STE #140",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303423372",
            "telephone_number": "678-720-8921"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MARLENE BELMONT SUKIENNIK, LCSW, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-09-26",
        "last_updated": "2014-09-26",
        "status": "A",
        "authorized_official_last_name": "SUKIENNIK",
        "authorized_official_first_name": "MARLENE",
        "authorized_official_title_or_position": "LICENSED CLINICAL SOCIAL WORKER",
        "authorized_official_telephone_number": "678-720-8921"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Social Worker, Clinical",
            "state": "GA",
            "license": "CSW005178",
            "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 Sep 26, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.