Individual provider Active NPI

Carol Huff, LCSW

  • Clinical Social Worker
  • Dallas, GA
National Provider Identifier
1316316169
Registry record updated Nov 16, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
CSW005664 Issued in GA
Practice address
110 Evans Mill Dr Ste 306
Dallas, GA 30157-1623
Phone
(404) 500-9177
NPI assigned
Sep 23, 2015
Last updated
Nov 16, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 16, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 11402 LA
Clinical Social Worker 1041C0700X CSW005664 GA Primary

Addresses

Primary practice location

110 Evans Mill Dr Ste 306
Dallas, GA 30157-1623

Mailing address

57 Jessel LN
Douglasville, GA 30134-5901
Phone (404) 316-3352

Other practice location 1

57 Jessel Ln
Douglasville, GA 30134-5901
Phone (404) 316-3352

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
I20170628002673 GA Practitioner - Clinical Social Worker 5092084434 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
11402LAMDClinical 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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1442966400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1668556800000",
    "number": "1316316169",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "57 JESSEL LN",
            "city": "DOUGLASVILLE",
            "state": "GA",
            "postal_code": "301345901",
            "telephone_number": "404-316-3352"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "110 EVANS MILL DR STE 306",
            "city": "DALLAS",
            "state": "GA",
            "postal_code": "301571623",
            "telephone_number": "404-500-9177"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "57 Jessel Ln",
            "address_purpose": "LOCATION",
            "city": "Douglasville",
            "state": "GA",
            "postal_code": "301345901",
            "country_code": "US",
            "telephone_number": "404-316-3352",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HUFF",
        "first_name": "CAROL",
        "name_prefix": "Mrs.",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-09-23",
        "last_updated": "2022-11-16",
        "certification_date": "2022-11-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "LA",
            "license": "11402",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "GA",
            "license": "CSW005664",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dallas, GA

Sources for this page

Verify at the official NPI Registry.