Individual provider Active NPI

Isom Eugene White, LCSW

  • Clinical Social Worker
  • Smyrna, GA
National Provider Identifier
1265916464
Registry record updated Nov 10, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
CSW0006575 Issued in GA
Practice address
3499 S Cobb Dr SE Ste 209
Smyrna, GA 30080-4170
Phone
(678) 392-8173
NPI assigned
Sep 24, 2018
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 10, 2025

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 CSW0006575 GA Primary

Addresses

Primary practice location

3499 S Cobb Dr SE Ste 209
Smyrna, GA 30080-4170

Mailing address

3499 S Cobb Dr SE Ste 209
Smyrna, GA 30080-4170
Phone (678) 392-8173

Other identifiers 1

IdentifierTypeStateIssuer
CSW006575OtherGASTATE OF GEORGIA

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
I20190129001964 GA Practitioner - Clinical Social Worker 4284971243

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
CSW0006575GAMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1537747200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1762732800000",
    "number": "1265916464",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3499 S COBB DR SE STE 209",
            "city": "SMYRNA",
            "state": "GA",
            "postal_code": "300804170",
            "telephone_number": "678-392-8173"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3499 S COBB DR SE STE 209",
            "city": "SMYRNA",
            "state": "GA",
            "postal_code": "300804170",
            "telephone_number": "678-392-8173"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WHITE",
        "first_name": "ISOM",
        "middle_name": "EUGENE",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-09-24",
        "last_updated": "2025-11-10",
        "certification_date": "2025-11-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "GA",
            "license": "CSW0006575",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE OF GEORGIA",
            "identifier": "CSW006575",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Smyrna, GA

Sources for this page

Verify at the official NPI Registry.