Active NPI
Donna Wilson-Fant, LCSW
- Social Worker
- Atlanta, GA
National Provider Identifier
1245519321
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Social Worker
- License
- CSW004421
- Practice address
- 341 Ponce de Leon Ave NE
Atlanta, GA 30308-2012 - Phone
- (404) 616-6614
- Fax
- (404) 616-9790
- NPI assigned
- Aug 8, 2011
- Last updated
- Aug 8, 2011
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Social Worker | 104100000X | CSW004421 | GA | Primary |
Addresses
Primary practice location
341 Ponce de Leon Ave NE
Atlanta, GA 30308-2012
Mailing address
238 Bridge GRV
Douglasville, GA 30134-5455
Phone (770) 709-1546
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 |
|---|---|---|---|
| CSW004421 | GA | MD | Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1312761600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1312761600000",
"number": "1245519321",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "238 BRIDGE GRV",
"city": "DOUGLASVILLE",
"state": "GA",
"postal_code": "301345455",
"telephone_number": "770-709-1546"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "341 PONCE DE LEON AVE NE",
"city": "ATLANTA",
"state": "GA",
"postal_code": "303082012",
"telephone_number": "404-616-6614",
"fax_number": "404-616-9790"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WILSON-FANT",
"first_name": "DONNA",
"name_prefix": "Mrs.",
"credential": "LCSW",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2011-08-08",
"last_updated": "2011-08-08",
"status": "A"
},
"taxonomies": [
{
"code": "104100000X",
"taxonomy_group": "",
"desc": "Social Worker",
"state": "GA",
"license": "CSW004421",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Atlanta, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 8, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.