Stephanie E. Moultrie, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

CSW004041 Issued in GA

Practice address

8201 Hazelbrand Rd NE
Covington, GA 30014-1510

Phone

(770) 787-3977

NPI assigned

Oct 21, 2008

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

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

{
    "created_epoch": "1224547200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1224547200000",
    "number": "1063664068",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 687",
            "city": "LAWRENCEVILLE",
            "state": "GA",
            "postal_code": "300460687"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8201 HAZELBRAND RD NE",
            "city": "COVINGTON",
            "state": "GA",
            "postal_code": "300141510",
            "telephone_number": "770-787-3977"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOULTRIE",
        "first_name": "STEPHANIE",
        "middle_name": "E.",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-10-21",
        "last_updated": "2008-10-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "GA",
            "license": "CSW004041",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Michelle D. Morgan, OTR/L
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• Matthew B Mote, D.O.
• Danielle Moulton
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• Sara Michelle Murphy, FNP-BC
• My Saviours Grace LLC
• Dana Lynn Myers, PHARM.D.

• Clinical Social Worker in Covington, GA
• Providers in Covington, GA by specialty
• Clinical Social Worker in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 21, 2008; 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.