Tiajuana Dillard, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

006461 Issued in GA

Practice address

267 Water Oak LN
Jonesboro, GA 30238-8604

Phone

(678) 779-5925

NPI assigned

Jun 7, 2019

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

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

{
    "created_epoch": "1559865600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1559865600000",
    "number": "1144889775",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "267 WATER OAK LN",
            "city": "JONESBORO",
            "state": "GA",
            "postal_code": "302388604",
            "telephone_number": "678-779-5925"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "267 WATER OAK LN",
            "city": "JONESBORO",
            "state": "GA",
            "postal_code": "302388604",
            "telephone_number": "678-779-5925"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DILLARD",
        "first_name": "TIAJUANA",
        "name_prefix": "Mrs.",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-06-07",
        "last_updated": "2019-06-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Social Worker, Clinical",
            "state": "GA",
            "license": "006461",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Cheickna Diarra, M.D.
• Shanavia Natae Dickerson
• Khanh T. Dinh, D.C.
• Michele Renee Dionne, MD
• Rose Marie Distefano, PHARMACIST
• Distinctively Yours of Georgia, Inc
• Nash Ditmetaroj, OD

• Clinical Social Worker in Jonesboro, GA
• Providers in Jonesboro, GA by specialty
• Clinical Social Worker in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 7, 2019; 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.