Individual provider Active NPI

Kaylee Simon, LCSW

  • Clinical Social Worker
  • Atlanta, GA
National Provider Identifier
1366836876
Registry record updated Nov 1, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
CSW006501 Issued in GA
Practice address
550 Pharr Rd NE Ste 605
Atlanta, GA 30305-3469
Phone
(678) 665-5465
Fax
(678) 705-2756
NPI assigned
Mar 23, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 1, 2020

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 CSW006501 GA Primary

Addresses

Primary practice location

550 Pharr Rd NE Ste 605
Atlanta, GA 30305-3469

Mailing address

550 Pharr Rd NE Ste 605
Atlanta, GA 30305-3469
Phone (678) 665-5465

Other practice location 1

1814 Clairmont Rd
Decatur, GA 30033-3405
Phone (404) 636-1457

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
CSW006501GAMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1427068800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1604188800000",
    "number": "1366836876",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "550 PHARR RD NE STE 605",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303053469",
            "telephone_number": "678-665-5465",
            "fax_number": "678-705-2756"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "550 PHARR RD NE STE 605",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303053469",
            "telephone_number": "678-665-5465",
            "fax_number": "678-705-2756"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1814 Clairmont Rd",
            "address_purpose": "LOCATION",
            "city": "Decatur",
            "state": "GA",
            "postal_code": "300333405",
            "country_code": "US",
            "telephone_number": "404-636-1457",
            "fax_number": "404-636-7449",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SIMON",
        "first_name": "KAYLEE",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-03-23",
        "last_updated": "2020-11-01",
        "certification_date": "2020-11-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "GA",
            "license": "CSW006501",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Atlanta, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 1, 2020; 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.