Individual provider Active NPI

Nancy D Chase, PHD., LCSW

  • Clinical Social Worker
  • Brookhaven, GA
National Provider Identifier
1225385586
Registry record updated Oct 27, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
CSW004704 Issued in GA
Practice address
2801 Buford Hwy NE
Suite T-65
Brookhaven, GA 30329-2149
Phone
(404) 735-7291
NPI assigned
Aug 6, 2012
Last updated
Oct 27, 2016By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 27, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X CSW004704 GA Primary

Addresses

Primary practice location

2801 Buford Hwy NE
Suite T-65
Brookhaven, GA 30329-2149

Mailing address

2801 Buford Hwy NE
Suite T-65
Brookhaven, GA 30329-2149
Phone (404) 735-7291

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
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
CSW004704GAMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1344211200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1477526400000",
    "number": "1225385586",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2801 BUFORD HWY NE",
            "address_2": "SUITE T-65",
            "city": "BROOKHAVEN",
            "state": "GA",
            "postal_code": "303292149",
            "telephone_number": "404-735-7291"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2801 BUFORD HWY NE",
            "address_2": "SUITE T-65",
            "city": "BROOKHAVEN",
            "state": "GA",
            "postal_code": "303292149",
            "telephone_number": "404-735-7291"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHASE",
        "first_name": "NANCY",
        "middle_name": "D",
        "name_prefix": "Dr.",
        "credential": "PHD., LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-08-06",
        "last_updated": "2016-10-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "GA",
            "license": "CSW004704",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brookhaven, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 27, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.