Individual provider Active NPI

Robert Marlow Jr., LCSW

  • Clinical Social Worker
  • Valdosta, GA
National Provider Identifier
1073905618
Registry record updated Oct 5, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
SW22132 Issued in FL
Practice address
3120 N Oak Street Ext Ste B
Valdosta, GA 31602-5910
Phone
(229) 671-6170
NPI assigned
Feb 18, 2015
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 5, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X MCAP0100392 FL
Clinical Social Worker 1041C0700X SW22132 FL Primary

Addresses

Primary practice location

3120 N Oak Street Ext Ste B
Valdosta, GA 31602-5910

Mailing address

3698 Inner Perimeter Rd Unit 4142
Valdosta, GA 31604-7790
Phone (479) 567-9194

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
MCAP0100392FLMDAddiction (Substance Use Disorder) Counselor
SW22132FLMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1424217600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1696464000000",
    "number": "1073905618",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3698 INNER PERIMETER RD UNIT 4142",
            "city": "VALDOSTA",
            "state": "GA",
            "postal_code": "316047790",
            "telephone_number": "479-567-9194"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3120 N OAK STREET EXT STE B",
            "city": "VALDOSTA",
            "state": "GA",
            "postal_code": "316025910",
            "telephone_number": "229-671-6170"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARLOW",
        "first_name": "ROBERT",
        "name_prefix": "Mr.",
        "name_suffix": "Jr.",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-02-18",
        "last_updated": "2023-10-05",
        "certification_date": "2023-10-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "FL",
            "license": "MCAP0100392",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "FL",
            "license": "SW22132",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Valdosta, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 5, 2023; 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.