Charlene Byssainthe Kidd, LCSW

Primary specialty

Social WorkerTaxonomy code 104100000X

License

MSW009473 Issued in GA

Practice address

2905 E Point St Unit 90106
Atlanta, GA 30364-8604

Phone

(404) 913-4455

NPI assigned

Jan 22, 2021

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

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  • NPI 1700427820

  Multi-Specialty

  NPD (past)

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

{
    "created_epoch": "1611273600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1695945600000",
    "number": "1124618251",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2900 CHAMBLEE TUCKER RD BLDG 8",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303414100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2905 E POINT ST UNIT 90106",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303648604",
            "telephone_number": "404-913-4455"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2900 Chamblee Tucker Rd Bldg 8",
            "address_purpose": "LOCATION",
            "city": "Atlanta",
            "state": "GA",
            "postal_code": "303414100",
            "country_code": "US",
            "telephone_number": "678-259-9298",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3511 Orchard St",
            "address_purpose": "LOCATION",
            "city": "Clarkston",
            "state": "GA",
            "postal_code": "300211145",
            "country_code": "US",
            "telephone_number": "239-222-8949",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KIDD",
        "first_name": "CHARLENE",
        "middle_name": "BYSSAINTHE",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-01-22",
        "last_updated": "2023-09-29",
        "certification_date": "2023-09-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Social Worker",
            "state": "GA",
            "license": "MSW009473",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Gregory Kibler, PA-C
• Lisa Kiblinger
• Lindsay Susanne Kibuyaga, MD
• Kidcare Pediatrics
• Casandra M Kidd, DRPH
• Jordan Kidd, CPHT
• Shane Kidd
• Kidgroups, LLC
• Kidneyspa East Atlanta Dialysis, LLC
• Kids on the Move, LLC

• Social Worker in Atlanta, GA
• Providers in Atlanta, GA by specialty
• Social Worker in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 29, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.