Individual provider Active NPI

William Christopher Mayo, LCSW

  • Clinical Social Worker
  • Athens, GA
National Provider Identifier
1205039609
Registry record updated Dec 14, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
CSW004916 Issued in GA
Practice address
250 North Ave
Athens, GA 30601-2244
Phone
(706) 743-7539
Fax
(706) 743-7541
NPI assigned
Jun 6, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 14, 2009

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X
Clinical Social Worker 1041C0700X CSW004916 GA Primary

Addresses

Primary practice location

250 North Ave
Athens, GA 30601-2244

Mailing address

250 North Ave
Athens, GA 30601-2244
Phone (706) 542-9700

Other identifiers 2

IdentifierTypeStateIssuer
MSW004182OtherGALMSW
CSW004196OtherGASTATE LICENSE

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
CSW004916GAMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1181088000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1260748800000",
    "number": "1205039609",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "250 NORTH AVE",
            "city": "ATHENS",
            "state": "GA",
            "postal_code": "306012244",
            "telephone_number": "706-542-9700",
            "fax_number": "706-227-7249"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "250 NORTH AVE",
            "city": "ATHENS",
            "state": "GA",
            "postal_code": "306012244",
            "telephone_number": "706-743-7539",
            "fax_number": "706-743-7541"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAYO",
        "first_name": "WILLIAM",
        "middle_name": "CHRISTOPHER",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-06-06",
        "last_updated": "2009-12-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "GA",
            "license": "CSW004916",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LMSW",
            "identifier": "MSW004182",
            "state": "GA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE",
            "identifier": "CSW004196",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Athens, GA

Sources for this page

Verify at the official NPI Registry.