Individual provider Active NPI

Jane Butler Braxley, LCSW

  • Clinical Social Worker
  • Macon, GA
National Provider Identifier
1134328826
Registry record updated Jul 13, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
CSW000457 Issued in GA
Practice address
175 Emery Hwy
Macon, GA 31217-3692
Phone
(478) 751-4446
Fax
(478) 751-4444
NPI assigned
Jul 13, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2007

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 CSW000457 GA Primary

Addresses

Primary practice location

175 Emery Hwy
Macon, GA 31217-3692

Mailing address

175 Emery Hwy
Macon, GA 31217-3692
Phone (478) 751-4446

Other identifiers 1

IdentifierTypeStateIssuer
CSW000457OtherGALCSW

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
CSW000457GAMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1184284800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1184284800000",
    "number": "1134328826",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "175 EMERY HWY",
            "city": "MACON",
            "state": "GA",
            "postal_code": "312173692",
            "telephone_number": "478-751-4446",
            "fax_number": "478-751-4444"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "175 EMERY HWY",
            "city": "MACON",
            "state": "GA",
            "postal_code": "312173692",
            "telephone_number": "478-751-4446",
            "fax_number": "478-751-4444"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRAXLEY",
        "first_name": "JANE",
        "middle_name": "BUTLER",
        "name_prefix": "Mrs.",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-07-13",
        "last_updated": "2007-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "GA",
            "license": "CSW000457",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LCSW",
            "identifier": "CSW000457",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Macon, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2007; 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.