Active NPI
Ana Coronado
- Social Worker
- Lawrenceville, GA
National Provider Identifier
1326582859
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Social Worker
- License
- MSW06667
- Practice address
- 965 Oakland Road NW
Suite 3B
Lawrenceville, GA 30044 - Phone
- (470) 709-2350
- NPI assigned
- Dec 19, 2016
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Social Worker | 104100000X | MSW06667 | GA | Primary |
Addresses
Primary practice location
965 Oakland Road NW
Suite 3B
Lawrenceville, GA 30044
Mailing address
1017 Fayetteville Rd SE
Suite B
Atlanta, GA 30316-2932
Phone (470) 709-2350
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Opted out of Medicare
- Yes, effective Jan 21, 2024 through Jan 21, 2028
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| MSW06667 | GA | MD | Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1482105600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1482105600000",
"number": "1326582859",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1017 FAYETTEVILLE RD SE",
"address_2": "SUITE B",
"city": "ATLANTA",
"state": "GA",
"postal_code": "303162932",
"telephone_number": "470-709-2350"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "965 OAKLAND ROAD NW",
"address_2": "SUITE 3B",
"city": "LAWRENCEVILLE",
"state": "GA",
"postal_code": "30044",
"telephone_number": "470-709-2350"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CORONADO",
"first_name": "ANA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2016-12-19",
"last_updated": "2016-12-19",
"status": "A"
},
"taxonomies": [
{
"code": "104100000X",
"taxonomy_group": "",
"desc": "Social Worker",
"state": "GA",
"license": "MSW06667",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Lawrenceville, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 19, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.