Carol Ann Osbaldeston, LCSW – Clinical Social Worker

Key facts

NPI: 1336490952
Entity type: Individual (NPI type 1)
Primary specialty: Clinical Social Worker 1041C0700X
License: CSW004639 (GA)
Practice address: 175 Gwinnett Dr
Lawrenceville, GA 30046-8444
Phone: (770) 263-6285
Fax: (678) 990-8997
NPI assigned: Sep 21, 2012
Sex: Female
Sole proprietor: Yes

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 and National Provider Directory roles.

View Point Health Mental Health Clinic/Center (Including Community Mental Health Center) · Lawrenceville, GA · NPI 1609853860

Medicare reassignment NPD GA
Doctor on Demand Professionals P C Family Medicine Physician · San Francisco, CA · NPI 1174931448

Medicare reassignment NPD GA

Medicare participation

Medicare fee-for-service enrollment: Enrolled in GA
Eligible to order & refer: Part B services: Yes · DME: Yes · Home health: No · Power mobility devices: No · Hospice: No

Medicare enrollment records

Enrollment ID	State	Provider type	PAC ID	Details
I20121126000173	GA	Practitioner - Clinical Social Worker	2466603444	Reassigns benefits to 2 organizations

National Provider Directory

Medicare enrollment (NPD): Yes

Practice roles

Organization	Specialty	Status	New patients
View Point Health		Current since Oct 25, 2012	Accepting new patients
Doctor on Demand Professionals P C		Current since Apr 13, 2024	Accepting new patients

Locations

1 California St
Ste 2300
San Francisco, CA 94111
Phone (800) 929-0926

175 Gwinnett Dr
Lawrenceville, GA 30046
Phone (678) 209-2394

5030 Georgia Belle Ct
Ste 2036
Norcross, GA 30093
Phone (678) 209-2745

Interoperability endpoints

Direct secure messaging: carol.osbaldeston.1@30520.direct.athenahealth.com

Specialties & licenses

Specialty (taxonomy)	Code	License	State	Primary
Clinical Social Worker	1041C0700X	CSW004639	GA	Yes

Addresses

Primary practice location

175 Gwinnett Dr
Lawrenceville, GA 30046-8444

Mailing address

175 Gwinnett Dr
Lawrenceville, GA 30046-8444
Phone (770) 263-6285

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Sep 22, 2012.

{
    "created_epoch": "1348185600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1348272000000",
    "number": "1336490952",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "175 GWINNETT DR",
            "city": "LAWRENCEVILLE",
            "state": "GA",
            "postal_code": "300468444",
            "telephone_number": "770-263-6285",
            "fax_number": "678-990-8997"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "175 GWINNETT DR",
            "city": "LAWRENCEVILLE",
            "state": "GA",
            "postal_code": "300468444",
            "telephone_number": "770-263-6285",
            "fax_number": "678-990-8997"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OSBALDESTON",
        "first_name": "CAROL",
        "middle_name": "ANN",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-09-21",
        "last_updated": "2012-09-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "GA",
            "license": "CSW004639",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lawrenceville, GA

All providers in Lawrenceville, GA · Clinical Social Worker in Georgia

Sources for this page

NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 22, 2012. Information in NPPES is self-reported and not verified by CMS.
NUCC Health Care Provider Taxonomy: specialty names.
Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
Order and Referring (CMS).
National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.