Individual provider Active NPI

Rosalind B Haralson, LCSW

  • Clinical Social Worker
  • Atlanta, GA
National Provider Identifier
1255620027
Registry record updated Oct 3, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
CSW001848 Issued in GA
Practice address
35 Whitefoord Ave SE
Atlanta, GA 30317-1727
Phone
(404) 588-0104
NPI assigned
Apr 1, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 3, 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 CSW001848 GA Primary

Addresses

Primary practice location

35 Whitefoord Ave SE
Atlanta, GA 30317-1727

Mailing address

1353 George W Brumley Way SE
Atlanta, GA 30317-1743
Phone (404) 523-2500

Other identifiers 3

IdentifierTypeStateIssuer
003108715BMedicaidGA
003108715CMedicaidGA
003108715AMedicaidGA

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

LicenseStateTypeSpecialty
CSW001848GAMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1301616000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1317600000000",
    "number": "1255620027",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1353 GEORGE W BRUMLEY WAY SE",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303171743",
            "telephone_number": "404-523-2500"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "35 WHITEFOORD AVE SE",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303171727",
            "telephone_number": "404-588-0104"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HARALSON",
        "first_name": "ROSALIND",
        "middle_name": "B",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-04-01",
        "last_updated": "2011-10-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "GA",
            "license": "CSW001848",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "003108715B",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "003108715C",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "003108715A",
            "state": "GA"
        }
    ],
    "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 Oct 3, 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.