Active NPI
Georgia Fannin, LMSW
- Clinical Social Worker
- Marksville, LA
National Provider Identifier
1205645389
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 18261
- Practice address
- 110 E Mark St
Marksville, LA 71351-2414 - Phone
- (318) 240-7278
- NPI assigned
- Jan 3, 2025
- Last updated
- Jan 3, 2025
- Sex
- Female
- Sole proprietor
- No
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 | 18261 | LA | Primary |
Addresses
Primary practice location
110 E Mark St
Marksville, LA 71351-2414
Mailing address
1000 Chinaberry Dr Ste 900
Bossier City, LA 71111-2455
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 |
|---|---|---|---|
| 18261 | LA | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1735862400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1735862400000",
"number": "1205645389",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1000 CHINABERRY DR STE 900",
"city": "BOSSIER CITY",
"state": "LA",
"postal_code": "711112455"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "110 E MARK ST",
"city": "MARKSVILLE",
"state": "LA",
"postal_code": "713512414",
"telephone_number": "318-240-7278"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FANNIN",
"first_name": "GEORGIA",
"credential": "LMSW",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2025-01-03",
"last_updated": "2025-01-03",
"certification_date": "2025-01-03",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "LA",
"license": "18261",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Marksville, LA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 3, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.