Individual provider Active NPI

Christine Head, LSWAIC

  • Clinical Social Worker
  • Jasper, GA
National Provider Identifier
1194139170
Registry record updated May 10, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
CSW009056 Issued in GA
Practice address
64 Martin Farm Rd
Jasper, GA 30143-5710
Phone
(706) 383-3826
NPI assigned
Jun 17, 2014
Last updated
May 10, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 10, 2026

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X CSW009056 GA Primary
Clinical Social Worker 1041C0700X SC60838766 WA
Clinical Social Worker 1041C0700X 0904020424 VA

Addresses

Primary practice location

64 Martin Farm Rd
Jasper, GA 30143-5710

Mailing address

64 Martin Farm Rd
Jasper, GA 30143-5710
Phone (253) 283-1213

Other practice location 1

3930 Pender Dr Ste 60
Fairfax, VA 22030-0991
Phone (571) 582-1183

Other identifiers 1

IdentifierTypeStateIssuer
SC60838766OtherWALSWAIC

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

LicenseStateTypeSpecialty
CSW009056GAMDClinical Social Worker
0904020424VAMDClinical Social Worker
SC60838766WAMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1402963200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1778371200000",
    "number": "1194139170",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "64 MARTIN FARM RD",
            "city": "JASPER",
            "state": "GA",
            "postal_code": "301435710",
            "telephone_number": "253-283-1213"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "64 MARTIN FARM RD",
            "city": "JASPER",
            "state": "GA",
            "postal_code": "301435710",
            "telephone_number": "706-383-3826"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3930 Pender Dr Ste 60",
            "address_purpose": "LOCATION",
            "city": "Fairfax",
            "state": "VA",
            "postal_code": "220300991",
            "country_code": "US",
            "telephone_number": "571-582-1183",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HEAD",
        "first_name": "CHRISTINE",
        "credential": "LSWAIC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-06-17",
        "last_updated": "2026-05-10",
        "certification_date": "2026-05-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "GA",
            "license": "CSW009056",
            "primary": true
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "WA",
            "license": "SC60838766",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "VA",
            "license": "0904020424",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LSWAIC",
            "identifier": "SC60838766",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Jasper, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 10, 2026; 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.