Otis Chandler, LCSW
Individual provider Active NPI Clinical Social Worker · Peachtree Corners, GA
NPI 1215212642 · NPPES record last updated Jan 22, 2017
Key facts
- NPI
- 1215212642
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Clinical Social Worker 1041C0700X
- License
- CSW005989 (GA)
- Practice address
- 5960 Crooked Creek Rd
Suite 140-F
Peachtree Corners, GA 30092-6219 - Phone
- (404) 664-4517
- NPI assigned
- Oct 17, 2011
- Sex
- Male
- Sole proprietor
- Yes
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: No · DME: Yes · Home health: No · Power mobility devices: No · Hospice: No
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 17210 | MD | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Recovery Unlimited LLC | Current |
Accepting new patients |
Locations
8335 Office Park Dr
#A
Douglasville, GA 30134
Phone (678) 324-0476
5960 Crooked Creek Rd
Ste 140F
Peachtree Corners, GA 30092
Phone (404) 664-4517
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Social Worker | 104100000X | 17210 | MD | |
| Clinical Social Worker | 1041C0700X | CSW005989 | GA | Yes |
Addresses
Primary practice location
5960 Crooked Creek Rd
Suite 140-F
Peachtree Corners, GA 30092-6219
Mailing address
2765 Hidden Creek Dr
Loganville, GA 30052-7595
Phone (404) 664-4517
Other providers in Peachtree Corners, GA
- Center for Pan Asian Community Services, Inc.
- Center for Pan Asian Community Services, Inc.
- Ritu Chadha
- Kittiya Chaiyachati
- Jennie Chambliss
- Chen Chen
- Lisa Chen
- Children'S Eye Care and Surgery of Georgia PC
- Michael K Choi
- Christopher R. Sellars, DO, LLC
All providers in Peachtree Corners, 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 Jan 22, 2017. 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.