Individual provider Active NPI

Lauri Shedd, LCSW

  • Clinical Social Worker
  • Carrollton, GA
National Provider Identifier
1285183483
Registry record updated Oct 31, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
2016024037 Issued in MO
Practice address
1325 S Park St # 1003
Carrollton, GA 30117-4433
Phone
(314) 882-0282
Fax
(470) 870-8554
NPI assigned
Sep 28, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 31, 2023

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 2016024037 MO Primary

Addresses

Primary practice location

1325 S Park St # 1003
Carrollton, GA 30117-4433

Mailing address

1325 S Park St # 1003
Carrollton, GA 30117-4433
Phone (314) 882-0282

Other names 1

  • Lauri Tyeryar Former name

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
I20230122000024 GA Practitioner - Clinical Social Worker 3072850858 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Florida State University College of Medicine, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

Carrollton, GA 30117
Phone (314) 882-0282

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2016024037MOMDClinical Social Worker

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": "1475020800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1698710400000",
    "number": "1285183483",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1325 S PARK ST # 1003",
            "city": "CARROLLTON",
            "state": "GA",
            "postal_code": "301174433",
            "telephone_number": "314-882-0282",
            "fax_number": "470-870-8544"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1325 S PARK ST # 1003",
            "city": "CARROLLTON",
            "state": "GA",
            "postal_code": "301174433",
            "telephone_number": "314-882-0282",
            "fax_number": "470-870-8554"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHEDD",
        "first_name": "LAURI",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-09-28",
        "last_updated": "2023-10-31",
        "certification_date": "2023-10-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MO",
            "license": "2016024037",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "LAURI",
            "last_name": "TYERYAR",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Carrollton, GA

Sources for this page

Verify at the official NPI Registry.