Individual provider Active NPI

Patricia Tatro, LCSW

  • Clinical Social Worker
  • Decatur, GA
National Provider Identifier
1063853976
Registry record updated Sep 8, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
CSW001940 Issued in GA
Practice address
403 W Ponce de Leon Ave Ste 102
Decatur, GA 30030-2445
Phone
(404) 277-0026
Fax
(404) 687-0281
NPI assigned
Jul 9, 2013
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 8, 2022

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 CSW001940 GA Primary

Addresses

Primary practice location

403 W Ponce de Leon Ave Ste 102
Decatur, GA 30030-2445

Mailing address

403 W Ponce de Leon Ave Ste 102
Decatur, GA 30030-2445
Phone (404) 277-0026

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

State licenses

LicenseStateTypeSpecialty
CSW001940GAMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1373328000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1662595200000",
    "number": "1063853976",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "403 W PONCE DE LEON AVE STE 102",
            "city": "DECATUR",
            "state": "GA",
            "postal_code": "300302445",
            "telephone_number": "404-277-0026",
            "fax_number": "404-687-0281"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "403 W PONCE DE LEON AVE STE 102",
            "city": "DECATUR",
            "state": "GA",
            "postal_code": "300302445",
            "telephone_number": "404-277-0026",
            "fax_number": "404-687-0281"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TATRO",
        "first_name": "PATRICIA",
        "name_prefix": "Ms.",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-07-09",
        "last_updated": "2022-09-08",
        "certification_date": "2022-09-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "GA",
            "license": "CSW001940",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Decatur, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 8, 2022; 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.