Organization Active NPI

Ann Priddy LCSW PC

  • Community/Behavioral Health Agency
  • Albany, GA
National Provider Identifier
1134489503
Registry record updated Jun 11, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Behavioral Health AgencyTaxonomy code 251S00000X
License
CSW001337 Issued in GA
Legal business name
ANN PRIDDY LCSW PC
Practice address
1511 W 3Rd Ave
Suite 104
Albany, GA 31707-3695
Phone
(229) 483-5050
Fax
(229) 485-1103
NPI assigned
May 20, 2012
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 11, 2012

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

Authorized official

Name
Ms. Ann S. Priddy, LCSW LMFTNPI 1982688198
Title
Owner
Phone
(229) 483-5050

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Behavioral Health Agency 251S00000X CSW001337 GA Primary

Addresses

Primary practice location

1511 W 3Rd Ave
Suite 104
Albany, GA 31707-3695

Mailing address

1511 W 3Rd Ave
Suite 104
Albany, GA 31707-3695
Phone (229) 483-5050

Other identifiers 2

IdentifierTypeStateIssuer
899829779AMedicaidGA
1982688198OtherGAINDIVIDUAL NPI NUMBER

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20120703000508 GA Part B Supplier - Clinic/Group Practice 4082879622 Receives reassigned benefits from 1 practitioner
Practice locations: Albany, GA

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1337472000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1339372800000",
    "number": "1134489503",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1511 W 3RD AVE",
            "address_2": "SUITE 104",
            "city": "ALBANY",
            "state": "GA",
            "postal_code": "317073695",
            "telephone_number": "229-483-5050",
            "fax_number": "229-485-1103"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1511 W 3RD AVE",
            "address_2": "SUITE 104",
            "city": "ALBANY",
            "state": "GA",
            "postal_code": "317073695",
            "telephone_number": "229-483-5050",
            "fax_number": "229-485-1103"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ANN PRIDDY LCSW PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-05-20",
        "last_updated": "2012-06-11",
        "status": "A",
        "authorized_official_last_name": "PRIDDY",
        "authorized_official_first_name": "ANN",
        "authorized_official_middle_name": "S.",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "229-483-5050",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "LCSW LMFT"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "GA",
            "license": "CSW001337",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "899829779A",
            "state": "GA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "INDIVIDUAL NPI NUMBER",
            "identifier": "1982688198",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Albany, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 11, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.