Individual provider Active NPI

Lynn Lane

  • Clinical Social Worker
  • Atlanta, GA
National Provider Identifier
1104183847
Registry record updated Apr 19, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
CSW003023 Issued in GA
Practice address
1050 Crown Pointe Pkwy
Ste 450
Atlanta, GA 30338-7707
Phone
(866) 325-5434
Fax
(866) 325-5340
NPI assigned
Apr 19, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 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 CSW003023 GA Primary

Addresses

Primary practice location

1050 Crown Pointe Pkwy
Ste 450
Atlanta, GA 30338-7707

Mailing address

118 Stewart St
St Simons Island, GA 31522-2737
Phone (912) 580-7204

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
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 1

Enrollment IDStateProvider typePAC IDDetails
I20120606000068 GA Practitioner - Clinical Social Worker 3971767815 Reassigns benefits to 1 organization
Practice locations: Dahlonega, GA; Roswell, GA

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

555 Sun Valley Dr
Suite P4
Roswell, GA 30076-5633
Phone (678) 381-1687

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
CSW003023GAMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Peachtree Psychology CurrentSince Jan 2, 2018 Accepting new patients
Senior Psych Solutions Corp Clinical Past Accepting new patients

Locations

555 Sun Valley Dr
Ste P4
Roswell, GA 30076
Phone (678) 381-1681

Organizations & group practices 2

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": "1334793600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1334793600000",
    "number": "1104183847",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "118 STEWART ST",
            "city": "ST SIMONS ISLAND",
            "state": "GA",
            "postal_code": "315222737",
            "telephone_number": "912-580-7204"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1050 CROWN POINTE PKWY",
            "address_2": "STE 450",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303387707",
            "telephone_number": "866-325-5434",
            "fax_number": "866-325-5340"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LANE",
        "first_name": "LYNN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-04-19",
        "last_updated": "2012-04-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "GA",
            "license": "CSW003023",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Atlanta, GA

Sources for this page

Verify at the official NPI Registry.