Latorja J O'Bryant, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

CSW004597 Issued in GA

Practice address

1 Freedom Way
Augusta, GA 30904-6258

Phone

(706) 733-0188

NPI assigned

Dec 12, 2005

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1134345600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1389916800000",
    "number": "1326023409",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3523 CRAWFORDVILLE DR",
            "city": "AUGUSTA",
            "state": "GA",
            "postal_code": "309099437",
            "telephone_number": "706-589-3414",
            "fax_number": "706-481-6791"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 FREEDOM WAY",
            "city": "AUGUSTA",
            "state": "GA",
            "postal_code": "309046258",
            "telephone_number": "706-733-0188"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "O'BRYANT",
        "first_name": "LATORJA",
        "middle_name": "J",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2005-12-12",
        "last_updated": "2014-01-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "GA",
            "license": "MSW003517",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "GA",
            "license": "CSW004597",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000606317B",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Michelle Nye
• Sean Michael O Toole, MD
• Alyson Kirkland O'Banion, MPT
• Davis O'Brien
• Dina P. O'Brien, PHD
• Whitney O'Connor, LPC
• Sheila Ann O'Grady, CRNA
• Ryan O'Hagan, AGACNP-BC
• Keith F. O'Malley, M.D.
• James Joseph O'Meara III, PT

• Clinical Social Worker in Augusta, GA
• Providers in Augusta, 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 Jan 17, 2014; 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.