Beverly Knighten, LCSW
Individual provider Active NPI Clinical Social Worker · Augusta, GA
NPI 1205940509 · NPPES record last updated Mar 12, 2020
Key facts
- NPI
- 1205940509
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Clinical Social Worker 1041C0700X
- License
- 7117 (OK)
- Practice address
- 1 Freedom Way
Augusta, GA 30904-6258 - Phone
- (706) 733-0188
- NPI assigned
- Aug 17, 2006
- Sex
- Female
- Sole proprietor
- Yes
Organizations & group practices 17
Medicare Care Compare profile
- Specialty
- Clinical Social Worker
- Education
- Other, 2001
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- East Georgia Healthcare Center, Inc.
Practice addresses (Care Compare)
215 N Coleman St
Swainsboro, GA 30401-3530
Phone (478) 237-2638
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 |
|---|---|---|---|---|
| I20180928002726 | GA | Practitioner - Clinical Social Worker | 4880945963 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2283-C | AR | MD | Clinical Social Worker |
| 4950 | KS | MD | Speech-Language Pathologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| East Georgia Healthcare Center, Inc. | Current |
Accepting new patients | |
| East Georgia Healthcare Center, Inc. | Multi-Specialty | Current | Accepting new patients |
| East Georgia Healthcare Center, Inc. | Current |
Accepting new patients |
Locations
215 N Coleman St
Swainsboro, GA 30401
Phone (478) 237-2638
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Social Worker | 104100000X | 4950 | KS | |
| Clinical Social Worker |
1041C0700X | CSW005914 | GA | |
| Clinical Social Worker |
1041C0700X | 7117 | OK | Yes |
| Clinical Social Worker | 1041C0700X | 2283-C | AR |
Addresses
Primary practice location
1 Freedom Way
Augusta, GA 30904-6258
Mailing address
3101 Elk Dr
McAlester, OK 74501-7606
Phone (229) 584-2540
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 4950 | Other | KS | MASTER SOCIAL WORKER |
| 2283-C | Other | AR | LCSW |
Other providers in Augusta, GA
- KMZ Healthcare & Wellness
- Thomas Knapp
- Knight Personal Care Home Center
- Mark Douglas Knight
- Mary Odom Knight
- Racheal Kniphfer
- Kathryn A. Knodel
- Kent Knoernschild
- Clarissa Maria Knotts
- Michelle H. Knox
All providers in Augusta, 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 Mar 12, 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).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.