Individual provider Active NPI

Mark Joshua Stanga, LMSW, MS, BS

  • Clinical Social Worker
  • Atlanta, GA
National Provider Identifier
1043048085
Registry record updated Jul 22, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
MSW008489 Issued in GA
Practice address
21 Ferry Landing LN NW Unit 1414
Atlanta, GA 30305-1672
Phone
(504) 717-6234
NPI assigned
Jul 22, 2024
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 22, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X MSW008489 GA Primary

Addresses

Primary practice location

21 Ferry Landing LN NW Unit 1414
Atlanta, GA 30305-1672

Mailing address

21 Ferry Landing LN NW Unit 1414
Atlanta, GA 30305-1672
Phone (504) 717-6234

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Bachelor of Science, Master of Science

State licenses

LicenseStateTypeSpecialty
MSW008489GAMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1721606400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1721606400000",
    "number": "1043048085",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "21 FERRY LANDING LN NW UNIT 1414",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303051672",
            "telephone_number": "504-717-6234"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "21 FERRY LANDING LN NW UNIT 1414",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303051672",
            "telephone_number": "504-717-6234"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STANGA",
        "first_name": "MARK",
        "middle_name": "JOSHUA",
        "credential": "LMSW, MS, BS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2024-07-22",
        "last_updated": "2024-07-22",
        "certification_date": "2024-07-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "GA",
            "license": "MSW008489",
            "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 Jul 22, 2024; 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.