Individual provider Active NPI

David Shane Donaldson, LCSW

  • Clinical Social Worker
  • Snellville, GA
National Provider Identifier
1184243073
Registry record updated Jan 26, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
CSW007061 Issued in GA
Practice address
2386 Clower St Ste D102
Snellville, GA 30078-6108
Phone
(404) 889-6223
NPI assigned
Apr 10, 2020
Last updated
Jan 26, 2023By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 26, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X CSW007061 GA Primary

Addresses

Primary practice location

2386 Clower St Ste D102
Snellville, GA 30078-6108

Mailing address

1873 Raintree CT
Snellville, GA 30078-2117
Phone (404) 889-6223

Other practice location 1

1873 Raintree Ct
Snellville, GA 30078-2117
Phone (404) 889-6223

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200928001338 GA Practitioner - Clinical Social Worker 1557780418 Reassigns benefits to 1 organization
Practice locations: Snellville, GA; Lawrenceville, GA

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1873 Raintree CT
Snellville, GA 30078-2117
Phone (404) 889-6223

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
CSW007061GAMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
A Way of Being Psychotherapy and Consulting Clinical CurrentSince Aug 13, 2022 Accepting new patients

Locations

2386 Clower St
Ste D102
Snellville, GA 30078
Phone (404) 889-6223

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1586476800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1674691200000",
    "number": "1184243073",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1873 RAINTREE CT",
            "city": "SNELLVILLE",
            "state": "GA",
            "postal_code": "300782117",
            "telephone_number": "404-889-6223"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2386 CLOWER ST STE D102",
            "city": "SNELLVILLE",
            "state": "GA",
            "postal_code": "300786108",
            "telephone_number": "404-889-6223"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1873 Raintree Ct",
            "address_purpose": "LOCATION",
            "city": "Snellville",
            "state": "GA",
            "postal_code": "300782117",
            "country_code": "US",
            "telephone_number": "404-889-6223",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DONALDSON",
        "first_name": "DAVID",
        "middle_name": "SHANE",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-04-10",
        "last_updated": "2023-01-26",
        "certification_date": "2023-01-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "GA",
            "license": "CSW007061",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Snellville, GA

Sources for this page

Verify at the official NPI Registry.