Active NPI
Patrick Bryant, LCSW
- Clinical Social Worker
- Decatur, GA
National Provider Identifier
1285067686
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- CSW004964
- Practice address
- 1799 Clairmont Rd
Decatur, GA 30033-4005 - Phone
- (404) 490-0664
- NPI assigned
- Aug 21, 2013
- Sex
- Male
- Sole proprietor
- No
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 | CSW004964 | GA | Primary |
Addresses
Primary practice location
1799 Clairmont Rd
Decatur, GA 30033-4005
Mailing address
1799 Clairmont Rd
Decatur, GA 30033-4005
Phone (404) 490-0664
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Opted out of Medicare
- Yes, effective Jan 16, 2024 through Jan 16, 2028
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| CSW004964 | GA | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1377043200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1450656000000",
"number": "1285067686",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1799 CLAIRMONT RD",
"city": "DECATUR",
"state": "GA",
"postal_code": "300334005",
"telephone_number": "404-490-0664"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1799 CLAIRMONT RD",
"city": "DECATUR",
"state": "GA",
"postal_code": "300334005",
"telephone_number": "404-490-0664"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BRYANT",
"first_name": "PATRICK",
"credential": "LCSW",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2013-08-21",
"last_updated": "2015-12-21",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "GA",
"license": "CSW004964",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Decatur, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 21, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.