Active NPI
Casey Mintz Beise, LCSW
- Clinical Social Worker
- Tucker, GA
National Provider Identifier
1336617786
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- CSW006556
- Practice address
- 1479 Brockett Rd Ste 100
Tucker, GA 30084-7326 - Phone
- (770) 375-8124
- NPI assigned
- Nov 4, 2018
- Last updated
- Nov 4, 2018
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | CSW006556 | GA | Primary |
Addresses
Primary practice location
1479 Brockett Rd Ste 100
Tucker, GA 30084-7326
Mailing address
1479 Brockett Rd Ste 100
Tucker, GA 30084-7326
Phone (770) 375-8124
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| CSW006556 | Other | GA | GEORGIA COMPOSITE BOARD OF PC, SW, AND MFT CLINICAL SOCIAL WORKER |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| CSW006556 | GA | MD | Clinical Social Worker |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Healthy Minds Psychology Associates Inc | Clinical | Past | Accepting new patients |
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": "1541289600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1541289600000",
"number": "1336617786",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1479 BROCKETT RD STE 100",
"city": "TUCKER",
"state": "GA",
"postal_code": "300847326",
"telephone_number": "770-375-8124"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1479 BROCKETT RD STE 100",
"city": "TUCKER",
"state": "GA",
"postal_code": "300847326",
"telephone_number": "770-375-8124"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BEISE",
"first_name": "CASEY",
"middle_name": "MINTZ",
"name_prefix": "Mrs.",
"credential": "LCSW",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2018-11-04",
"last_updated": "2018-11-04",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "GA",
"license": "CSW006556",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "GEORGIA COMPOSITE BOARD OF PC, SW, AND MFT CLINICAL SOCIAL WORKER",
"identifier": "CSW006556",
"state": "GA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Tucker, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 4, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.