Active NPI
Kharesea Beckworth Jennings, LCSW
- Clinical Social Worker
- Acworth, GA
National Provider Identifier
1164161014
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- CSW007903
- Practice address
- 4720 Ridgewood Creek Dr NW
Acworth, GA 30102-3483 - Phone
- (678) 913-9554
- NPI assigned
- May 31, 2022
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | CSW007903 | GA | Primary |
Addresses
Primary practice location
4720 Ridgewood Creek Dr NW
Acworth, GA 30102-3483
Mailing address
4720 Ridgewood Creek Dr NW
Acworth, GA 30102-3483
Phone (678) 913-9554
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| CSW007903 | GA | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1653955200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1653955200000",
"number": "1164161014",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4720 RIDGEWOOD CREEK DR NW",
"city": "ACWORTH",
"state": "GA",
"postal_code": "301023483",
"telephone_number": "678-913-9554"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4720 RIDGEWOOD CREEK DR NW",
"city": "ACWORTH",
"state": "GA",
"postal_code": "301023483",
"telephone_number": "678-913-9554"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JENNINGS",
"first_name": "KHARESEA",
"middle_name": "BECKWORTH",
"credential": "LCSW",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2022-05-31",
"last_updated": "2022-05-31",
"certification_date": "2022-05-31",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "GA",
"license": "CSW007903",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Acworth, GA
- Shirley May James, LMT
- Stephanie Jameson
- Jamestown Holdings (Interim Healthcare of Paulding County)
- Jasmine West (Hope Stone Services)
- Annelle Jean-Jacques, LMSW
- Tara Haynes Jiminez, MA, LPC
- Kirkley Griffeth Jock, FNP-BC
- John H Hamel DDS PC (Biologic Dentistry)
- Melakiya Bradley Johnson, EDD
- Valerie Kay Johnson
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 31, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.