Individual provider Active NPI

Carol Johnson, LCSW

  • Clinical Social Worker
  • Macon, GA
National Provider Identifier
1053998666
Registry record updated Mar 28, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
CSW007515 Issued in GA
Practice address
1900 Wesleyan Dr Apt 2206
Macon, GA 31210-8830
Phone
(205) 356-5251
NPI assigned
Mar 28, 2021
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 28, 2021

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 CSW007515 GA Primary

Addresses

Primary practice location

1900 Wesleyan Dr Apt 2206
Macon, GA 31210-8830

Mailing address

1900 Wesleyan Dr Apt 2206
Macon, GA 31210-8830
Phone (205) 356-5251

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
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 1

Enrollment IDStateProvider typePAC IDDetails
I20250205002832 GA Practitioner - Clinical Social Worker 1951831924 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Arts

State licenses

LicenseStateTypeSpecialty
CSW007515GAMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Mental Health Specialty Group PA CurrentSince Jan 23, 2025 Accepting new patients
Psychiatric Professionals of Georgia, LLC CurrentSince Feb 17, 2025 Accepting new patients

Locations

3424 Peachtree Rd NE
Ste 2200
Atlanta, GA 30326
Phone (404) 436-2563

3825 Medical Park Dr
Ste 102
Austell, GA 30106
Phone (678) 439-0003

1325 Satellite Blvd NW
Ste 400
Suwanee, GA 30024
Phone (470) 713-0414

500 Westover Dr
Sanford, NC 27330
Phone (478) 766-4000

Organizations & group practices 2

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": "1616889600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1616889600000",
    "number": "1053998666",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1900 WESLEYAN DR APT 2206",
            "city": "MACON",
            "state": "GA",
            "postal_code": "312108830",
            "telephone_number": "205-356-5251"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1900 WESLEYAN DR APT 2206",
            "city": "MACON",
            "state": "GA",
            "postal_code": "312108830",
            "telephone_number": "205-356-5251"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "CAROL",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-03-28",
        "last_updated": "2021-03-28",
        "certification_date": "2021-03-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "GA",
            "license": "CSW007515",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Macon, GA

Sources for this page

Verify at the official NPI Registry.