Individual provider Active NPI

Tiffany Maria Taylor, MSW, LCSW

  • Clinical Social Worker
  • Smyrna, GA
National Provider Identifier
1366737223
Registry record updated Jun 17, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
CSW004447 Issued in GA
Practice address
4579 S Cobb Dr SE
Suite 600
Smyrna, GA 30080-6999
Phone
(678) 838-8333
Fax
(678) 838-8444
NPI assigned
Jun 17, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 17, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X CSW004447 GA Primary

Addresses

Primary practice location

4579 S Cobb Dr SE
Suite 600
Smyrna, GA 30080-6999

Mailing address

4579 S Cobb Dr SE
Suite 600
Smyrna, GA 30080-6999
Phone (678) 838-8333

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

LicenseStateTypeSpecialty
CSW004447GAMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Soul Solutions Therapeutic Services, LLC Current 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 and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1308268800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1308268800000",
    "number": "1366737223",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4579 S COBB DR SE",
            "address_2": "SUITE 600",
            "city": "SMYRNA",
            "state": "GA",
            "postal_code": "300806999",
            "telephone_number": "678-838-8333",
            "fax_number": "678-838-8444"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4579 S COBB DR SE",
            "address_2": "SUITE 600",
            "city": "SMYRNA",
            "state": "GA",
            "postal_code": "300806999",
            "telephone_number": "678-838-8333",
            "fax_number": "678-838-8444"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TAYLOR",
        "first_name": "TIFFANY",
        "middle_name": "MARIA",
        "credential": "MSW, LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-06-17",
        "last_updated": "2011-06-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "GA",
            "license": "CSW004447",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Smyrna, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 17, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.