Individual provider Active NPI

Antoinette Numital Thornton, LCSW

  • Clinical Social Worker
  • Atlanta, GA
National Provider Identifier
1114299690
Registry record updated Dec 5, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
CSW04839 Issued in GA
Practice address
3915 Cascade Rd SW
Suite T-138
Atlanta, GA 30331-8512
Phone
(404) 692-0818
NPI assigned
Jan 31, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 5, 2023

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 0904007839 VA
Clinical Social Worker 1041C0700X CSW04839 GA Primary

Addresses

Primary practice location

3915 Cascade Rd SW
Suite T-138
Atlanta, GA 30331-8512

Mailing address

3915 Cascade Rd SW
Suite T-138
Atlanta, GA 30331-8512
Phone (404) 692-0818

Other practice location 1

910 Great Bridge Blvd
Chesapeake, VA 23320-6642
Phone (757) 770-5618

Other practice location 2

1216 Granby St Ste 206
Norfolk, VA 23510-2622
Phone (844) 580-5678

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
CSW04839GAMDClinical Social Worker
0904007839VAMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Innovative Options Incorporated PastSince Apr 16, 2023 Accepting new patients
Innovative Options Incorporated Clinical Past Accepting new patients

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": "1327968000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1701734400000",
    "number": "1114299690",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3915 CASCADE RD SW",
            "address_2": "SUITE T-138",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303318512",
            "telephone_number": "404-692-0818"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3915 CASCADE RD SW",
            "address_2": "SUITE T-138",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303318512",
            "telephone_number": "404-692-0818"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "910 Great Bridge Blvd",
            "address_purpose": "LOCATION",
            "city": "Chesapeake",
            "state": "VA",
            "postal_code": "233206642",
            "country_code": "US",
            "telephone_number": "757-770-5618",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1216 Granby St Ste 206",
            "address_purpose": "LOCATION",
            "city": "Norfolk",
            "state": "VA",
            "postal_code": "235102622",
            "country_code": "US",
            "telephone_number": "844-580-5678",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "THORNTON",
        "first_name": "ANTOINETTE",
        "middle_name": "NUMITAL",
        "name_prefix": "Dr.",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-01-31",
        "last_updated": "2023-12-05",
        "certification_date": "2023-12-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "VA",
            "license": "0904007839",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "GA",
            "license": "CSW04839",
            "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 Dec 5, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.