Individual provider Active NPI

Rebekah Ruth Tchouta

  • Clinical Social Worker
  • Woodstock, GA
National Provider Identifier
1275093437
Registry record updated Sep 22, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
CSW007121 Issued in GA
Practice address
5166 Shotwell St
Woodstock, GA 30188
Phone
(812) 606-4298
NPI assigned
Mar 23, 2019
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 22, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social WorkerGroup: 193400000X SINGLE SPECIALTY GROUP 1041C0700X CSW007121 GA Primary
Social Worker 104100000X MSW007438 GA

Addresses

Primary practice location

5166 Shotwell St
Woodstock, GA 30188

Mailing address

5166 Shotwell St
Woodstock, GA 30188
Phone (812) 606-4298

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
I20250411003007 GA Practitioner - Clinical Social Worker 0840714705 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Psychiatry and Wellness of Georgia, LLCGroup PAC ID 7810351608, 7 clinicians

Practice addresses (Care Compare)

620 Colonial Park Dr
Suite 100
Roswell, GA 30075-3839
Phone (678) 439-0017

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
MSW007438GAMDSocial Worker
CSW007121GAMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Psychiatry and Wellness of Georgia, LLC Single Specialty CurrentSince Feb 8, 2025 Accepting new patients

Locations

620 Colonial Park Dr
Ste 100
Roswell, GA 30075
Phone (678) 439-0017

Organizations & group practices 1

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": "1553299200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1758499200000",
    "number": "1275093437",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5166 SHOTWELL ST",
            "city": "WOODSTOCK",
            "state": "GA",
            "postal_code": "30188",
            "telephone_number": "812-606-4298"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5166 SHOTWELL ST",
            "city": "WOODSTOCK",
            "state": "GA",
            "postal_code": "30188",
            "telephone_number": "812-606-4298"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TCHOUTA",
        "first_name": "REBEKAH",
        "middle_name": "RUTH",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-03-23",
        "last_updated": "2025-09-22",
        "certification_date": "2025-09-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Social Worker, Clinical",
            "state": "GA",
            "license": "CSW007121",
            "primary": true
        },
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "GA",
            "license": "MSW007438",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Woodstock, GA

Sources for this page

Verify at the official NPI Registry.