Individual provider Active NPI

Jennifer Hancock Walker, LSW

  • Clinical Social Worker
  • Woodstock, GA
National Provider Identifier
1104212893
Registry record updated Jun 7, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
CSW007152 Issued in GA
Practice address
4595 Towne Lake Pkwy
Building 300 Suite 250
Woodstock, GA 30189-5514
Phone
(267) 325-5300
NPI assigned
Apr 9, 2015
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 7, 2024

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 CSW007152 GA Primary

Addresses

Primary practice location

4595 Towne Lake Pkwy
Building 300 Suite 250
Woodstock, GA 30189-5514

Mailing address

2145 Whittingham CT
Roswell, GA 30075-8102
Phone (267) 325-5300

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
I20250114003883 GA Practitioner - Clinical Social Worker 6406384791 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

4595 Towne Lake Pkwy
BLDG 300 250
Woodstock, GA 30189-5571
Phone (770) 695-2020

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
CSW007152GAMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
New Heights Therapy LLC CurrentSince Sep 23, 2024 Accepting new patients

Locations

4595 Towne Lake Pkwy
Bldg 300250
Woodstock, GA 30189

4595 Towne Lake Pkwy
Bldg 300-250
Woodstock, GA 30189
Phone (770) 695-2020

4595 Towne Lake Pkwy
Bldg 300
Woodstock, GA 30189
Phone (678) 592-5779

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1428537600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1717718400000",
    "number": "1104212893",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2145 WHITTINGHAM CT",
            "city": "ROSWELL",
            "state": "GA",
            "postal_code": "300758102",
            "telephone_number": "267-325-5300",
            "fax_number": "423-822-5729"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4595 TOWNE LAKE PKWY",
            "address_2": "BUILDING 300 SUITE 250",
            "city": "WOODSTOCK",
            "state": "GA",
            "postal_code": "301895514",
            "telephone_number": "267-325-5300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WALKER",
        "first_name": "JENNIFER",
        "middle_name": "HANCOCK",
        "name_prefix": "Ms.",
        "credential": "LSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-04-09",
        "last_updated": "2024-06-07",
        "certification_date": "2024-06-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "GA",
            "license": "CSW007152",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Woodstock, GA

Sources for this page

Verify at the official NPI Registry.