Active NPI
Christi Perry Hardeman, LCSW
- Clinical Social Worker
- Stockbridge, GA
National Provider Identifier
1255736617
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- CSW005202
- Practice address
- 160 Memory LN
Stockbridge, GA 30281-6263 - Phone
- (678) 596-9477
- NPI assigned
- Oct 28, 2014
- 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 |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | CSW005202 | GA | Primary |
Addresses
Primary practice location
160 Memory LN
Stockbridge, GA 30281-6263
Mailing address
160 Memory LN
Stockbridge, GA 30281-6263
Phone (678) 596-9477
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 003154573A | Medicaid | GA |
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
| License | State | Type | Specialty |
|---|---|---|---|
| CSW005202 | GA | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1414454400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1433808000000",
"number": "1255736617",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "160 MEMORY LN",
"city": "STOCKBRIDGE",
"state": "GA",
"postal_code": "302816263",
"telephone_number": "678-596-9477"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "160 MEMORY LN",
"city": "STOCKBRIDGE",
"state": "GA",
"postal_code": "302816263",
"telephone_number": "678-596-9477"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HARDEMAN",
"first_name": "CHRISTI",
"middle_name": "PERRY",
"credential": "LCSW",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2014-10-28",
"last_updated": "2015-06-09",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "GA",
"license": "CSW005202",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "003154573A",
"state": "GA"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Stockbridge, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 9, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.