Swan Counseling and Coaching, LLC

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

Legal business name

SWAN COUNSELING AND COACHING, LLC

Practice address

278 Waleska Rd
Canton, GA 30114-2441

Phone

(770) 953-4744

NPI assigned

Dec 21, 2018

Organization subpart

No

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

Authorized official

Name

Andrea Moody, LCSWNPI 1457727190

Title

Provider

Phone

(770) 953-4744

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in GA

Enrollment records 1

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Andrea Moody, LCSW

  • Clinical Social Worker
  • Lawrenceville, GA
  • NPI 1457727190
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1545350400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1545350400000",
    "number": "1245702786",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1827 POWERS FERRY RD SE BLDG 22",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303395621"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "278 WALESKA RD",
            "city": "CANTON",
            "state": "GA",
            "postal_code": "301142441",
            "telephone_number": "770-953-4744"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1827 Powers Ferry Rd SE Bldg 22",
            "address_purpose": "LOCATION",
            "city": "Atlanta",
            "state": "GA",
            "postal_code": "303395621",
            "country_code": "US",
            "telephone_number": "770-953-4744",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "SWAN COUNSELING AND COACHING, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-12-21",
        "last_updated": "2018-12-21",
        "status": "A",
        "authorized_official_last_name": "MOODY",
        "authorized_official_first_name": "ANDREA",
        "authorized_official_title_or_position": "PROVIDER",
        "authorized_official_telephone_number": "770-953-4744",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sure Path Wellness and Psychotherapy, LLC
• Suresight and Associates L L C (Suresight Eyecare Canton)
• Erin Bardonner Sustachek, APRN
• Megan Lena Wander Suter, CPNP-PC
• Joshua V Swain
• Swords and Phelps
• Edwin Ira Swords III, D.D.S.
• Brian L Taffin, R.PH.
• Alex Seth Talley, PT
• Jack L. Talley, PH.D.

• Clinical Social Worker in Canton, GA
• Providers in Canton, GA by specialty
• Clinical Social Worker in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 21, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.