Individual provider Active NPI

Tiffany Way, LCSW

  • Clinical Social Worker
  • Atlanta, GA
National Provider Identifier
1265783146
Registry record updated Jan 12, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
CSW006088 Issued in GA
Practice address
3355 Lenox Rd NE Ste 750
Atlanta, GA 30326-1353
Phone
(215) 789-8100
NPI assigned
Oct 2, 2012
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 12, 2018

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 CSW006088 GA Primary

Addresses

Primary practice location

3355 Lenox Rd NE Ste 750
Atlanta, GA 30326-1353

Mailing address

3355 Lenox Rd NE Ste 750
Atlanta, GA 30326-1353
Phone (215) 789-8100

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20191213001516 GA Practitioner - Clinical Social Worker 1355774894 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
CSW006088GAMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Personal Recovery Network LLC CurrentSince Nov 25, 2019 Accepting new patients
Accelerated Recovery Centers Past Accepting new patients

Locations

2801 Buford Hwy NE
Ste 100
Brookhaven, GA 30329
Phone (678) 820-7830

250 Corporate Center Ct
Stockbridge, GA 30281
Phone (770) 954-8685

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1349136000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1515715200000",
    "number": "1265783146",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3355 LENOX RD NE STE 750",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303261353",
            "telephone_number": "215-789-8100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3355 LENOX RD NE STE 750",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303261353",
            "telephone_number": "215-789-8100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WAY",
        "first_name": "TIFFANY",
        "name_prefix": "Ms.",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-10-02",
        "last_updated": "2018-01-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "GA",
            "license": "CSW006088",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Atlanta, GA

Sources for this page

Verify at the official NPI Registry.