NPIMap

Organization Active NPI

Inner Changellc, Counseling and Education Center

  • Clinical Social Worker
  • Atlanta, GA
National Provider Identifier
1184081564
Registry record updated Jan 15, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
CSW001981 Issued in GA
Legal business name
INNER CHANGELLC, COUNSELING AND EDUCATION CENTER
Practice address
3600 Dekalb Technology Pkwy
Suite140
Atlanta, GA 30340-3612
Phone
(404) 989-3114
Fax
(470) 282-5102
NPI assigned
Jan 15, 2016
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 15, 2016

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

Authorized official

Name
Sherri Anne Gatson, LCSWNPI 1780901165
Title
Co-Founder
Phone
(404) 989-3114

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
Clinical Social WorkerGroup: 193400000X SINGLE SPECIALTY GROUP 1041C0700X CSW001981 GA Primary

Addresses

Primary practice location

3600 Dekalb Technology Pkwy
Suite140
Atlanta, GA 30340-3612

Mailing address

3600 Dekalb Technology Pkwy
Suite140
Atlanta, GA 30340-3612
Phone (404) 989-3114

Other identifiers 1

IdentifierTypeStateIssuer
003136433AMedicaidGA

National Provider Directory

National Provider Directory

Locations

3600 DeKalb Technology Pkwy
Ste 140
Atlanta, GA 30340
Phone (404) 803-8873

Practitioners & affiliated clinicians

Practitioners 2

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": "1452816000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1452816000000",
    "number": "1184081564",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3600 DEKALB TECHNOLOGY PKWY",
            "address_2": "SUITE140",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303403612",
            "telephone_number": "404-989-3114",
            "fax_number": "470-282-5102"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3600 DEKALB TECHNOLOGY PKWY",
            "address_2": "SUITE140",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303403612",
            "telephone_number": "404-989-3114",
            "fax_number": "470-282-5102"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INNER CHANGELLC, COUNSELING AND EDUCATION CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-01-15",
        "last_updated": "2016-01-15",
        "status": "A",
        "authorized_official_last_name": "GATSON",
        "authorized_official_first_name": "SHERRI",
        "authorized_official_middle_name": "ANNE",
        "authorized_official_title_or_position": "CO-FOUNDER",
        "authorized_official_telephone_number": "404-989-3114",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Social Worker, Clinical",
            "state": "GA",
            "license": "CSW001981",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "003136433A",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Atlanta, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 15, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.