Individual provider Active NPI

Bobbie Girardeau, LCSW

  • Clinical Social Worker
  • Flowery Branch, GA
National Provider Identifier
1245525286
Registry record updated Jun 17, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
CSW001988 Issued in GA
Practice address
4331 Thurmond Tanner Pkwy
Flowery Branch, GA 30542-2829
Phone
(678) 513-5700
Fax
(678) 513-5836
NPI assigned
Jun 17, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 17, 2011

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 CSW001988 GA Primary

Addresses

Primary practice location

4331 Thurmond Tanner Pkwy
Flowery Branch, GA 30542-2829

Mailing address

5700 Fernside Dr
Toccoa, GA 30577-8942
Phone (706) 282-4542

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
CSW001988GAMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1308268800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1308268800000",
    "number": "1245525286",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5700 FERNSIDE DR",
            "city": "TOCCOA",
            "state": "GA",
            "postal_code": "305778942",
            "telephone_number": "706-282-4542",
            "fax_number": "706-282-4544"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4331 THURMOND TANNER PKWY",
            "city": "FLOWERY BRANCH",
            "state": "GA",
            "postal_code": "305422829",
            "telephone_number": "678-513-5700",
            "fax_number": "678-513-5836"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GIRARDEAU",
        "first_name": "BOBBIE",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-06-17",
        "last_updated": "2011-06-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "GA",
            "license": "CSW001988",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Flowery Branch, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 17, 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.

Verify at the official NPI Registry.