Individual provider Active NPI

Rita Grayson, LCSW

  • Clinical Social Worker
  • Suwanee, GA
National Provider Identifier
1285655704
Registry record updated May 26, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
CSW029575 Issued in GA
Practice address
5000 Research CT
Suite 725
Suwanee, GA 30024-6609
Phone
(678) 557-4144
Fax
(770) 840-0162
NPI assigned
Jul 21, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 26, 2008

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 CSW029575 GA Primary

Addresses

Primary practice location

5000 Research CT
Suite 725
Suwanee, GA 30024-6609

Mailing address

630 Wintergate CT
Alpharetta, GA 30022-5584
Phone (770) 417-1004

Other identifiers 1

IdentifierTypeStateIssuer
00968734AMedicaidGA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
CSW029575GAMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
John'S Creek Counseling, L.L.C. Clinical Past Accepting new patients

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": "1153440000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1211760000000",
    "number": "1285655704",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "630 WINTERGATE CT",
            "city": "ALPHARETTA",
            "state": "GA",
            "postal_code": "300225584",
            "telephone_number": "770-417-1004",
            "fax_number": "770-840-0162"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5000 RESEARCH CT",
            "address_2": "SUITE 725",
            "city": "SUWANEE",
            "state": "GA",
            "postal_code": "300246609",
            "telephone_number": "678-557-4144",
            "fax_number": "770-840-0162"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRAYSON",
        "first_name": "RITA",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-21",
        "last_updated": "2008-05-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "GA",
            "license": "CSW029575",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00968734A",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Suwanee, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 26, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.