Individual provider Active NPI

Kelly Collier, LCSW

  • Clinical Social Worker
  • Smyrna, GA
National Provider Identifier
1083114680
Registry record updated Feb 20, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
CSW006308 Issued in GA
Practice address
1330 Concord Rd SE Ste 104
Smyrna, GA 30080-4373
Phone
(770) 315-6641
NPI assigned
Feb 20, 2018
Last updated
Feb 20, 2018By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 20, 2018

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 CSW006308 GA Primary

Addresses

Primary practice location

1330 Concord Rd SE Ste 104
Smyrna, GA 30080-4373

Mailing address

4921 Martin Farms Dr
Powder Springs, GA 30127-8429
Phone (770) 315-6641

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
I20200402000594 GA Practitioner - Clinical Social Worker 7911336961 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

1330 Concord Rd SE
Smyrna, GA 30080-4373
Phone (770) 315-6641

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
CSW006308GAMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Careview Counseling LLC Clinical CurrentSince Feb 10, 2020 Accepting new patients

Locations

1330 Concord Rd SE
Smyrna, GA 30080
Phone (770) 315-6641

1330 Concord Rd SE
Ste 104
Smyrna, GA 30080
Phone (404) 771-2277

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1519084800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1519084800000",
    "number": "1083114680",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4921 MARTIN FARMS DR",
            "city": "POWDER SPRINGS",
            "state": "GA",
            "postal_code": "301278429",
            "telephone_number": "770-315-6641"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1330 CONCORD RD SE STE 104",
            "city": "SMYRNA",
            "state": "GA",
            "postal_code": "300804373",
            "telephone_number": "770-315-6641"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COLLIER",
        "first_name": "KELLY",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-02-20",
        "last_updated": "2018-02-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "GA",
            "license": "CSW006308",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Smyrna, GA

Sources for this page

Verify at the official NPI Registry.