Individual provider Active NPI

Cherysh L Green-Caldwell, LMSW

  • Social Worker
  • Ashburn, GA
National Provider Identifier
1184299570
Registry record updated Dec 12, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
License
CSW008183 Issued in GA
Practice address
433 Goss Dr
Ashburn, GA 31714-5114
Phone
(229) 296-2013
NPI assigned
May 26, 2021
Last updated
Dec 12, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 12, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X MSW008585 GA
Social Worker 104100000X CSW008183 GA Primary

Addresses

Primary practice location

433 Goss Dr
Ashburn, GA 31714-5114

Mailing address

PO Box 2823
Ashburn, GA 31714-2823
Phone (229) 296-2013

Other practice location 1

1345 Redmond Cir NW
Rome, GA 30165-1307
Phone (910) 742-9243

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
MSW008585GAMDSocial Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Lifesource of North Carolina CurrentSince Jan 1, 2025 Accepting new patients
Lifesource of North Carolina CurrentSince Jan 1, 2025 Accepting new patients

Locations

1345 Redmond Cir NW
Rome, GA 30165
Phone (706) 234-8281

Organizations & group practices 2

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": "1621987200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1733961600000",
    "number": "1184299570",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2823",
            "city": "ASHBURN",
            "state": "GA",
            "postal_code": "317142823",
            "telephone_number": "229-296-2013"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "433 GOSS DR",
            "city": "ASHBURN",
            "state": "GA",
            "postal_code": "317145114",
            "telephone_number": "229-296-2013"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1345 Redmond Cir NW",
            "address_purpose": "LOCATION",
            "city": "Rome",
            "state": "GA",
            "postal_code": "301651307",
            "country_code": "US",
            "telephone_number": "910-742-9243",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GREEN-CALDWELL",
        "first_name": "CHERYSH",
        "middle_name": "L",
        "credential": "LMSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-05-26",
        "last_updated": "2024-12-12",
        "certification_date": "2024-12-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "GA",
            "license": "MSW008585",
            "primary": false
        },
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "GA",
            "license": "CSW008183",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ashburn, GA

Sources for this page

Verify at the official NPI Registry.