Active NPI
Kay L Gresham, LCSW MAC SAP SAE
- Clinical Social Worker
- Martinez, GA
National Provider Identifier
1366689457
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 002457
- Practice address
- 4210 Columbia Rd Ste 4a
Martinez, GA 30907-0403 - Phone
- (706) 993-5186
- NPI assigned
- Jan 12, 2009
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 10117 | SC | |
| Clinical Social Worker | 1041C0700X | 002457 | GA | Primary |
Addresses
Primary practice location
4210 Columbia Rd Ste 4a
Martinez, GA 30907-0403
Mailing address
PO Box 5664
Augusta, GA 30916-5664
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 002457 | GA | MD | Clinical Social Worker |
| 10117 | SC | MD | Orofacial Pain Dentist |
Interoperability endpoints
- kay.gresham.1@28394.direct.athenahealth.com
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1231718400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1462838400000",
"number": "1366689457",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 5664",
"city": "AUGUSTA",
"state": "GA",
"postal_code": "309165664"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4210 COLUMBIA RD STE 4A",
"city": "MARTINEZ",
"state": "GA",
"postal_code": "309070403",
"telephone_number": "706-993-5186"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GRESHAM",
"first_name": "KAY",
"middle_name": "L",
"name_prefix": "Ms.",
"credential": "LCSW MAC SAP SAE",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2009-01-12",
"last_updated": "2016-05-10",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "SC",
"license": "10117",
"primary": false
},
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "GA",
"license": "002457",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Martinez, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 10, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.