Marsha Tillman Carlton, LCSW

Individual provider Active NPI Clinical Social Worker · Moultrie, GA

NPI 1164050647 · NPPES record last updated Mar 30, 2020

Key facts

NPI
1164050647
Entity type
Individual (NPI type 1)
Primary specialty
Clinical Social Worker 1041C0700X
License
CSW006949 (GA)
Practice address
3015 Veterans Pkwy S
Moultrie, GA 31788-6705
Phone
(912) 844-2250
Fax
(229) 891-9372
NPI assigned
Mar 30, 2020
Sex
Female
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
Part B services: No · DME: Yes · Home health: No · Power mobility devices: No · Hospice: No

National Provider Directory

Medicare enrollment (NPD)
Yes

State licenses

LicenseStateTypeSpecialty
CSW006949GAMDClinical Social Worker

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X CSW006949 GA Yes

Addresses

Primary practice location

3015 Veterans Pkwy S
Moultrie, GA 31788-6705

Mailing address

2412 Jacqueline Cir
Moultrie, GA 31768-6738
Phone (912) 844-2250

Other providers in Moultrie, GA

All providers in Moultrie, GA · Clinical Social Worker in Georgia

Sources for this page

Verify at the official NPI Registry.