Kimberly Brazis
Individual provider Active NPI Clinical Social Worker · Chamblee, GA
NPI 1154073435 · NPPES record last updated Jan 19, 2022
Key facts
- NPI
- 1154073435
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Clinical Social Worker 1041C0700X
- License
- MSW010193 (GA)
- Practice address
- 3720 Chamblee Dunwoody Rd Ste D2
Chamblee, GA 30341-2064 - Phone
- (678) 802-9355
- NPI assigned
- Jan 19, 2022
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| MSW010193 | GA | MD | Clinical Social Worker |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Modern Path. LLC | Past |
Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | MSW010193 | GA | Yes |
Addresses
Primary practice location
3720 Chamblee Dunwoody Rd Ste D2
Chamblee, GA 30341-2064
Mailing address
3720 Chamblee Dunwoody Rd Ste D2
Chamblee, GA 30341-2064
Other providers in Chamblee, GA
- Dillon Blankenship
- Shannon M Blankenship
- Andrea K Boc
- Keilani Body
- Adrian Box
- Sue A Brenner
- Tonia Louell Brightly
- Peter Sloane Bucci
- Angelique L Burke
- Carlos Javier Caraballo Guzman
All providers in Chamblee, GA · Clinical Social Worker in Georgia
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 19, 2022. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.