Individual provider Active NPI

Sierra Bloxson, LCSW

  • Clinical Social Worker
  • Stone Mountain, GA
National Provider Identifier
1093289183
Registry record updated Jan 11, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
CSW006066 Issued in GA
Practice address
5100 W Mountain St Apt N301
Stone Mountain, GA 30083-7419
Phone
(678) 559-9128
NPI assigned
Jan 11, 2019
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 11, 2019

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 CSW006066 GA Primary

Addresses

Primary practice location

5100 W Mountain St Apt N301
Stone Mountain, GA 30083-7419

Mailing address

5100 W Mountain St Apt N301
Stone Mountain, GA 30083-7419

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
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.

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2011
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

1801 Watermark Dr
Suite 200
Columbus, OH 43215-7088

8710 Wildlane Dr
South Charleston, OH 45368-9709

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
CSW006066GAMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1547164800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1547164800000",
    "number": "1093289183",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5100 W MOUNTAIN ST APT N301",
            "city": "STONE MOUNTAIN",
            "state": "GA",
            "postal_code": "300837419"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5100 W MOUNTAIN ST APT N301",
            "city": "STONE MOUNTAIN",
            "state": "GA",
            "postal_code": "300837419",
            "telephone_number": "678-559-9128"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLOXSON",
        "first_name": "SIERRA",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-01-11",
        "last_updated": "2019-01-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "GA",
            "license": "CSW006066",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Stone Mountain, GA

Sources for this page

Verify at the official NPI Registry.