Individual provider Active NPI

Kathy Brown-Bragg, MSW

  • Clinical Social Worker
  • Douglasville, GA
National Provider Identifier
1114357886
Registry record updated Feb 12, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
CSW005504 Issued in GA
Practice address
3400 Chapel Hill Rd
Douglasville, GA 30135-1739
Phone
(404) 973-8920
NPI assigned
Nov 18, 2013
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 12, 2021

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X MSW005517 GA
Clinical Social Worker 1041C0700X MSW005517 GA
School Social Worker 1041S0200X MSW005517 GA
Clinical Social Worker 1041C0700X CSW005504 GA Primary

Addresses

Primary practice location

3400 Chapel Hill Rd
Douglasville, GA 30135-1739

Mailing address

3400 Chapel Hill Rd
Douglasville, GA 30135-1739

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
I20260430000514 GA Order and Referring Only - Clinical Social Worker 3779837190

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
MSW005517GAMDSchool Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Navigating for Change Clinical PastSince Aug 30, 2016 Accepting new patients

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": "1384732800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1613088000000",
    "number": "1114357886",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3400 CHAPEL HILL RD",
            "city": "DOUGLASVILLE",
            "state": "GA",
            "postal_code": "301351739"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3400 CHAPEL HILL RD",
            "city": "DOUGLASVILLE",
            "state": "GA",
            "postal_code": "301351739",
            "telephone_number": "404-973-8920"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BROWN-BRAGG",
        "first_name": "KATHY",
        "credential": "MSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-11-18",
        "last_updated": "2021-02-12",
        "certification_date": "2021-02-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "GA",
            "license": "MSW005517",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "GA",
            "license": "MSW005517",
            "primary": false
        },
        {
            "code": "1041S0200X",
            "taxonomy_group": "",
            "desc": "Social Worker, School",
            "state": "GA",
            "license": "MSW005517",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "GA",
            "license": "CSW005504",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Douglasville, GA

Sources for this page

Verify at the official NPI Registry.