Peacewerks Center for Well-Being

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

CSW004387 Issued in GA

Legal business name

PEACEWERKS CENTER FOR WELL-BEING

Practice address

5420 Red Berry LN SW
Atlanta, GA 30331-7750

Phone

(678) 296-8687

NPI assigned

Feb 10, 2011

Organization subpart

No

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

Authorized official

Name

Mary Polly Boyd, LCSWNPI 1750710539

Title

Ceo

Phone

(678) 296-8687

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in VA

Enrollment records 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Mary Polly Boyd, LCSW

  • Clinical Social Worker
  • Atlanta, GA
  • NPI 1750710539

  VA

  Medicare reassignment Authorized official

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

{
    "created_epoch": "1297296000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1386288000000",
    "number": "1295032126",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5420 RED BERRY LN SW",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303317750",
            "telephone_number": "678-296-8687"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5420 RED BERRY LN SW",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303317750",
            "telephone_number": "678-296-8687"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PEACEWERKS CENTER FOR WELL-BEING",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-02-10",
        "last_updated": "2013-12-06",
        "status": "A",
        "authorized_official_last_name": "BOYD",
        "authorized_official_first_name": "MARY",
        "authorized_official_middle_name": "POLLY",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "678-296-8687",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Social Worker, Clinical",
            "state": "GA",
            "license": "CSW004387",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Gordon Peace, PT, DPT
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• Peach Behavioral Services LLC
• Peach Dental LLC
• Peach Optics
• Peach Pediatric Psychological Center

• Clinical Social Worker in Atlanta, GA
• Providers in Atlanta, 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 Dec 6, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.