Individual provider Active NPI

Robin Raflo, LCSW

  • Clinical Social Worker
  • Marietta, GA
National Provider Identifier
1093139198
Registry record updated May 11, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
CSW004831 Issued in GA
Practice address
2940 Johnson Ferry Rd Ste B-127
Marietta, GA 30062-8361
Phone
(678) 637-7166
Fax
(770) 414-0804
NPI assigned
Feb 10, 2014
Last updated
May 11, 2020By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 11, 2020

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 CSW004831 GA Primary

Addresses

Primary practice location

2940 Johnson Ferry Rd Ste B-127
Marietta, GA 30062-8361

Mailing address

2940 Johnson Ferry Rd Ste B-127
Marietta, GA 30062-8361
Phone (678) 637-7166

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
Eligible to order & refer
  • Part B services: No
  • 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
I20140312000351 GA Practitioner - Clinical Social Worker 7618107798 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Mindful Transitions, LLC Clinical CurrentSince Feb 1, 2014 Accepting new patients

Locations

2940 Johnson Ferry Rd
Ste B127
Marietta, GA 30062
Phone (678) 637-7166

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": "1391990400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1589155200000",
    "number": "1093139198",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2940 JOHNSON FERRY RD STE B-127",
            "city": "MARIETTA",
            "state": "GA",
            "postal_code": "300628361",
            "telephone_number": "678-637-7166",
            "fax_number": "770-414-0804"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2940 JOHNSON FERRY RD STE B-127",
            "city": "MARIETTA",
            "state": "GA",
            "postal_code": "300628361",
            "telephone_number": "678-637-7166",
            "fax_number": "770-414-0804"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RAFLO",
        "first_name": "ROBIN",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-02-10",
        "last_updated": "2020-05-11",
        "certification_date": "2020-05-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "GA",
            "license": "CSW004831",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Marietta, GA

Sources for this page

Verify at the official NPI Registry.