Carolyn M Minor, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

1499 Issued in GA

Practice address

1805 Herrington Rd BLDG 3-B
Lawrenceville, GA 30043-7987

Phone

(770) 596-1262

Fax

(770) 277-1092

NPI assigned

Jan 2, 2007

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• MK Psychotherapy, Inc.

  • Clinical Social Worker
  • Lawrenceville, GA
  • NPI 1851513923
  NPD (past)

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

{
    "created_epoch": "1167696000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1668470400000",
    "number": "1285791129",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2709 STERLING DR",
            "city": "LAWRENCEVILLE",
            "state": "GA",
            "postal_code": "300436122",
            "telephone_number": "770-596-1262",
            "fax_number": "770-277-1092"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1805 HERRINGTON RD BLDG 3-B",
            "city": "LAWRENCEVILLE",
            "state": "GA",
            "postal_code": "300437987",
            "telephone_number": "770-596-1262",
            "fax_number": "770-277-1092"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MINOR",
        "first_name": "CAROLYN",
        "middle_name": "M",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-01-02",
        "last_updated": "2022-11-15",
        "certification_date": "2022-11-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "GA",
            "license": "1499",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Catherine Milum, RDN, LD
• William Min, MD
• Mind Haven LLC
• Mindful Faith Psychiatry Care LLC
• Minding My Health Solutions LLC
• Makeda Minott
• Opal Hope Minott, LCSW
• Mira Chiropractic Clinic, LLC
• Kenyatta Mireku, MD
• Mirror Image Group, LLC

• Clinical Social Worker in Lawrenceville, GA
• Providers in Lawrenceville, GA by specialty
• Clinical Social Worker in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 15, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.