Lydia Breer, LCSW
Individual provider Active NPI Clinical Social Worker · Hoschton, GA
NPI 1194357913 · NPPES record last updated Feb 10, 2020
Key facts
- NPI
- 1194357913
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Clinical Social Worker 1041C0700X
- License
- CSW007010 (GA)
- Practice address
- 4073 Highway 53
Hoschton, GA 30548-2305 - Phone
- (770) 891-1928
- Fax
- (706) 658-0116
- NPI assigned
- Feb 10, 2020
- Sex
- Female
- Sole proprietor
- Yes
Organizations & group practices 2
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in GA
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: No · Power mobility devices: No · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20200711000001 | GA | Practitioner - Clinical Social Worker | 9830512656 | Reassigns benefits to 2 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| CSW007010 | GA | MD | Clinical Social Worker |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Grow Healthcare Group PA | Clinical | Current |
Accepting new patients |
| Northeast Georgia Psychological Services LLC | Current |
Accepting new patients |
Locations
66 W Flagler St
Ste 900
Miami, FL 33130
Phone (786) 244-7711
715 Peachtree St NE
Ste 100
Atlanta, GA 30308
Phone (202) 972-4964
4073 Highway 53
Hoschton, GA 30548
Phone (770) 882-5884
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | CSW007010 | GA | Yes |
Addresses
Primary practice location
4073 Highway 53
Hoschton, GA 30548-2305
Mailing address
4073 Highway 53
Hoschton, GA 30548-2305
Phone (770) 891-1928
Other providers in Hoschton, GA
- Britney Huali Borges
- Marc-Yriane Borieux
- Rebecca Grace Bouras
- Braselton Pediatrics, LLC
- Braselton Pediatrics, PC
- Lisa Kay Brennan
- Bridge Medix
- Amanda Brinkman
- Chelsey Brissey
- Shea Brock
All providers in Hoschton, GA · Clinical Social Worker in Georgia
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Feb 10, 2020. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.