Individual provider Active NPI

Cristina Jover Hambrick, LCSW

  • Clinical Social Worker
  • Decatur, GA
National Provider Identifier
1093070021
Registry record updated Jul 19, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
CSW004697 Issued in GA
Practice address
120 E Trinity PL
Decatur, GA 30030-3302
Phone
(404) 378-2300
NPI assigned
Jul 5, 2012
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 19, 2012

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 CSW004697 GA Primary

Addresses

Primary practice location

120 E Trinity PL
Decatur, GA 30030-3302

Mailing address

86 Hudson PL SE
Atlanta, GA 30317-2951
Phone (404) 966-1235

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Opted out of Medicare
Yes, effective Mar 4, 2025 through Mar 4, 2027

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
CSW004697GAMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1341446400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1342656000000",
    "number": "1093070021",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "86 HUDSON PL SE",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303172951",
            "telephone_number": "404-966-1235"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "120 E TRINITY PL",
            "city": "DECATUR",
            "state": "GA",
            "postal_code": "300303302",
            "telephone_number": "404-378-2300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAMBRICK",
        "first_name": "CRISTINA",
        "middle_name": "JOVER",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-07-05",
        "last_updated": "2012-07-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "GA",
            "license": "CSW004697",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Decatur, GA

Sources for this page

Verify at the official NPI Registry.