Individual provider Active NPI

Natasha Williams Herrin, LSCSW

  • Clinical Social Worker
  • Waycross, GA
National Provider Identifier
1093299356
Registry record updated Feb 2, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
CSW006543 Issued in GA
Practice address
1007 Mary St
Waycross, GA 31503-3823
Phone
(912) 449-7100
NPI assigned
Sep 21, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 2, 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 CSW006543 GA Primary

Addresses

Primary practice location

1007 Mary St
Waycross, GA 31503-3823

Mailing address

6959 Hacklebarney Rd
Blackshear, GA 31516-4692
Phone (912) 670-1299

Other practice location 1

1600 N Lorraine St Ste 202
Hutchinson, KS 67501-5600
Phone (620) 663-7595

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA, KS2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20181030001115 GA Practitioner - Clinical Social Worker 0941553473 Reassigns benefits to 1 organization
I20220203001631 KS Practitioner - Clinical Social Worker 0941553473 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
CSW006543GAMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Thrive Counseling LLC CurrentSince Dec 3, 2021 Accepting new patients
Teladoc Health Medical Group, P.a. Clinical Current Accepting new patients
Center for Counseling and Consultation CurrentSince Feb 4, 2022 Accepting new patients
Big Umbrella Counseling Past Accepting new patients
Pawnee Mental Health Service, Inc. Past Accepting new patients

Locations

8800 Roswell Rd
Ste A135
Sandy Springs, GA 30350
Phone (617) 395-5806

5815 Broadway Ave
Great Bend, KS 67530
Phone (620) 792-2544

Interoperability endpoints

  • Direct secure messaging: natashaherrin@tdh.allscriptsdirect.net

Organizations & group practices 5

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": "1537488000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1643760000000",
    "number": "1093299356",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6959 HACKLEBARNEY RD",
            "city": "BLACKSHEAR",
            "state": "GA",
            "postal_code": "315164692",
            "telephone_number": "912-670-1299"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1007 MARY ST",
            "city": "WAYCROSS",
            "state": "GA",
            "postal_code": "315033823",
            "telephone_number": "912-449-7100"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1600 N Lorraine St Ste 202",
            "address_purpose": "LOCATION",
            "city": "Hutchinson",
            "state": "KS",
            "postal_code": "675015600",
            "country_code": "US",
            "telephone_number": "620-663-7595",
            "fax_number": "620-513-5098",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HERRIN",
        "first_name": "NATASHA",
        "middle_name": "WILLIAMS",
        "credential": "LSCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-09-21",
        "last_updated": "2022-02-02",
        "certification_date": "2022-02-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "GA",
            "license": "CSW006543",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Waycross, GA

Sources for this page

Verify at the official NPI Registry.