Individual provider Active NPI

Kiana Rosella Burgess, LCSW

  • Clinical Social Worker
  • Atlanta, GA
National Provider Identifier
1114539764
Registry record updated Jan 26, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
CSW007873 Issued in GA
Practice address
3030 Headland Dr SW Ste 600
Atlanta, GA 30311-5437
Phone
(470) 832-5973
Fax
(877) 887-5316
NPI assigned
Aug 17, 2020
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 26, 2026

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 CSW007873 GA Primary

Addresses

Primary practice location

3030 Headland Dr SW Ste 600
Atlanta, GA 30311-5437

Mailing address

3030 Headland Dr SW Ste 600
Atlanta, GA 30311-5437
Phone (470) 832-5973

Other identifiers 1

IdentifierTypeStateIssuer
Q176105196OtherGAMEDICARE

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address KGreen53@centerwell.eclincialdirectplus.com Direct

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
I20220412000896 GA Practitioner - Clinical Social Worker 3577959949 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
CSW007873GAMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Psychiatric Professionals of Georgia, LLC CurrentSince Jan 27, 2026 Accepting new patients

Locations

1397 Manchester Dr NE
Conyers, GA 30012
Phone (770) 922-0255

1325 Satellite Blvd NW
Ste 400
Suwanee, GA 30024
Phone (470) 713-0414

Interoperability endpoints

  • Direct secure messaging: kgreen53@centerwell.eclincialdirectplus.com

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": "1597622400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1769385600000",
    "number": "1114539764",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3030 HEADLAND DR SW STE 600",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303115437",
            "telephone_number": "470-832-5973",
            "fax_number": "877-887-5316"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3030 HEADLAND DR SW STE 600",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303115437",
            "telephone_number": "470-832-5973",
            "fax_number": "877-887-5316"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BURGESS",
        "first_name": "KIANA",
        "middle_name": "ROSELLA",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-08-17",
        "last_updated": "2026-01-26",
        "certification_date": "2026-01-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "GA",
            "license": "CSW007873",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE",
            "identifier": "Q176105196",
            "state": "GA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "KGreen53@centerwell.eclincialdirectplus.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "3030 Headland Dr SW Ste 600",
            "city": "Atlanta",
            "state": "GA",
            "country_code": "US",
            "postal_code": "303115437",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Atlanta, GA

Sources for this page

Verify at the official NPI Registry.