Individual provider Active NPI

Dairlyn J Chelette, MSW LCSW

  • Clinical Social Worker
  • Brookhaven, GA
National Provider Identifier
1083784417
Registry record updated Jan 30, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
CSW000477 Issued in GA
Practice address
2801 Buford Hwy NE
Ste 508
Brookhaven, GA 30329-2137
Phone
(678) 397-1189
NPI assigned
Nov 9, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 30, 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 CSW000477 GA Primary

Addresses

Primary practice location

2801 Buford Hwy NE
Ste 508
Brookhaven, GA 30329-2137

Mailing address

2801 Buford Hwy NE
Ste 508
Brookhaven, GA 30329-2137
Phone (770) 446-5642

Other identifiers 1

IdentifierTypeStateIssuer
300868553OtherGATAX ID

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
I20110826000111 GA Practitioner - Clinical Social Worker 3375713506 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1973
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

2801 Buford Hwy NE
Suite 508
Brookhaven, GA 30329-2137
Phone (678) 397-1189

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
CSW000477GAMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Dairlyn Chelette LCSW LLC CurrentSince Apr 30, 2015 Accepting new patients

Locations

4530 S Berkeley Lake Rd
Ste B
Berkeley Lake, GA 30071
Phone (678) 662-0029

2801 Buford Hwy NE
Ste 508
Brookhaven, GA 30329
Phone (404) 626-4387

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1163030400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1643500800000",
    "number": "1083784417",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2801 BUFORD HWY NE",
            "address_2": "STE 508",
            "city": "BROOKHAVEN",
            "state": "GA",
            "postal_code": "303292137",
            "telephone_number": "770-446-5642",
            "fax_number": "770-446-5643"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2801 BUFORD HWY NE",
            "address_2": "STE 508",
            "city": "BROOKHAVEN",
            "state": "GA",
            "postal_code": "303292137",
            "telephone_number": "678-397-1189"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHELETTE",
        "first_name": "DAIRLYN",
        "middle_name": "J",
        "credential": "MSW LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-11-09",
        "last_updated": "2022-01-30",
        "certification_date": "2022-01-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "GA",
            "license": "CSW000477",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TAX ID",
            "identifier": "300868553",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Brookhaven, GA

Sources for this page

Verify at the official NPI Registry.