Individual provider Active NPI

Lindsey Bustamante, LMSW

  • Social Worker
  • Jefferson, GA
National Provider Identifier
1336471499
Registry record updated Feb 1, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
License
MSW004839 Issued in GA
Practice address
383 General Jackson Dr
Jefferson, GA 30549-2909
Phone
(706) 542-9700
Fax
(706) 227-7249
NPI assigned
Feb 1, 2010
Last updated
Feb 1, 2010By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 1, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X MSW004839 GA Primary

Addresses

Primary practice location

383 General Jackson Dr
Jefferson, GA 30549-2909

Mailing address

250 North Ave
Athens, GA 30601-2244
Phone (706) 542-9700

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
I20151014003077 GA Practitioner - Clinical Social Worker 1658680624 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

390 Prospect PL
Alpharetta, GA 30005-5467
Phone (470) 991-1619

5235 Deerlake Dr
Alpharetta, GA 30005-3604

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
MSW004839GAMDSocial Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Bustamante Counseling CurrentSince Nov 2, 2020 Accepting new patients
Focus Forward Counseling and Consulting, Inc CurrentSince Jul 15, 2015 Accepting new patients

Locations

390 Prospect Pl
Alpharetta, GA 30005
Phone (678) 557-0934

5975 Parkway North Blvd
Ste 300D
Cumming, GA 30040
Phone (404) 388-3909

5975 Parkway North Blvd
Ste D
Cumming, GA 30040
Phone (404) 388-3909

Organizations & group practices 2

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": "1264982400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1264982400000",
    "number": "1336471499",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "250 NORTH AVE",
            "city": "ATHENS",
            "state": "GA",
            "postal_code": "306012244",
            "telephone_number": "706-542-9700",
            "fax_number": "706-227-7249"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "383 GENERAL JACKSON DR",
            "city": "JEFFERSON",
            "state": "GA",
            "postal_code": "305492909",
            "telephone_number": "706-542-9700",
            "fax_number": "706-227-7249"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BUSTAMANTE",
        "first_name": "LINDSEY",
        "credential": "LMSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-02-01",
        "last_updated": "2010-02-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "GA",
            "license": "MSW004839",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jefferson, GA

Sources for this page

Verify at the official NPI Registry.