Active NPI
Keldrin Ford, LCSW
- Clinical Social Worker
- Stone Mountain, GA
National Provider Identifier
1184399172
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- CSW007398
- Practice address
- 1555 Butternut CV
Stone Mountain, GA 30083-5238 - Phone
- (253) 820-4275
- NPI assigned
- Aug 11, 2021
- 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 | CSW007398 | GA | Primary |
Addresses
Primary practice location
1555 Butternut CV
Stone Mountain, GA 30083-5238
Mailing address
1555 Butternut CV
Stone Mountain, GA 30083-5238
Phone (253) 820-4275
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 |
|---|---|---|---|
| CSW007398 | GA | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1628640000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1628640000000",
"number": "1184399172",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1555 BUTTERNUT CV",
"city": "STONE MOUNTAIN",
"state": "GA",
"postal_code": "300835238",
"telephone_number": "253-820-4275"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1555 BUTTERNUT CV",
"city": "STONE MOUNTAIN",
"state": "GA",
"postal_code": "300835238",
"telephone_number": "253-820-4275"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FORD",
"first_name": "KELDRIN",
"name_prefix": "Ms.",
"credential": "LCSW",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2021-08-11",
"last_updated": "2021-08-11",
"certification_date": "2021-08-11",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "GA",
"license": "CSW007398",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Stone Mountain, GA
- James Floyd
- Kanani Daniels Floyd, PA-C
- Virginia Davis Floyd, MD, MPH
- Focused Health Private Home Care Services LLC
- Ford Family Service, Inc.
- Nioka Ford, CF-SLP
- Cynthia S Forrest, MA, PT
- Forthright Enterprises, Inc (Wholecare Pharmacy)
- Ursula Foster, MASSAGE THERAPIST
- Foundation of Exceptional Achievers, Inc. (Fea Works)
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 11, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.