Active NPI
Kalyn Danielle Wilson, LCSW
- Clinical Social Worker
- Atlanta, GA
National Provider Identifier
1093314478
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- CSW008278
- Practice address
- 5193 Peachtree Blvd Apt 3405
Atlanta, GA 30341-2867 - Phone
- (678) 313-2790
- NPI assigned
- Oct 18, 2020
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | CSW008278 | GA | Primary |
Addresses
Primary practice location
5193 Peachtree Blvd Apt 3405
Atlanta, GA 30341-2867
Mailing address
3631 Chamblee Tucker Rd Unit 941655
Atlanta, GA 31141-5029
Phone (678) 957-7691
Other practice location 1
1420 Ridgebend Way SE
Mableton, GA 30126-3643
Phone (404) 905-1344
Other practice location 2
26 Eagle Row NE
Atlanta, GA 30322-3643
Phone (404) 727-6714
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| CSW008278 | GA | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1602979200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1704240000000",
"number": "1093314478",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3631 CHAMBLEE TUCKER RD UNIT 941655",
"city": "ATLANTA",
"state": "GA",
"postal_code": "311415029",
"telephone_number": "678-957-7691"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5193 PEACHTREE BLVD APT 3405",
"city": "ATLANTA",
"state": "GA",
"postal_code": "303412867",
"telephone_number": "678-313-2790"
}
],
"practiceLocations": [
{
"address_1": "1420 Ridgebend Way SE",
"address_purpose": "LOCATION",
"city": "Mableton",
"state": "GA",
"postal_code": "301263643",
"country_code": "US",
"telephone_number": "404-905-1344",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "26 Eagle Row NE",
"address_purpose": "LOCATION",
"city": "Atlanta",
"state": "GA",
"postal_code": "303223643",
"country_code": "US",
"telephone_number": "404-727-6714",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "WILSON",
"first_name": "KALYN",
"middle_name": "DANIELLE",
"credential": "LCSW",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2020-10-18",
"last_updated": "2024-01-03",
"certification_date": "2023-12-25",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "GA",
"license": "CSW008278",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Atlanta, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 3, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.