Jill Sebaugh, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

CSW003368 Issued in GA

Practice address

3459 Acworth Due West Rd NW
Acworth, GA 30101-5819

Phone

(678) 310-4104

NPI assigned

Oct 1, 2010

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in GA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

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.

• Grow Healthcare Group PA

  • Mental Health Counselor
  • Miami, FL
  • NPI 1245845932

  GA

  Medicare reassignment

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

{
    "created_epoch": "1285891200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1670803200000",
    "number": "1376852848",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "999 MEDINAH CT NW",
            "city": "KENNESAW",
            "state": "GA",
            "postal_code": "301524743",
            "telephone_number": "678-213-2194",
            "fax_number": "678-354-5335"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3459 ACWORTH DUE WEST RD NW",
            "city": "ACWORTH",
            "state": "GA",
            "postal_code": "301015819",
            "telephone_number": "678-310-4104"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "732 Kennesaw Ave NW Ste 200",
            "address_purpose": "LOCATION",
            "city": "Marietta",
            "state": "GA",
            "postal_code": "300609406",
            "country_code": "US",
            "telephone_number": "678-310-4104",
            "fax_number": "678-354-5335",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SEBAUGH",
        "first_name": "JILL",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-10-01",
        "last_updated": "2022-12-12",
        "certification_date": "2022-12-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "GA",
            "license": "CSW003368",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Toya Veonn Scott-Roberson, PTA
• Jenna Scott, ND
• Omar Scott
• Zachary Scoville
• Beatrice Latisha Scriven, LCSW
• Select Surgical, LLC
• William Scott Sellers, DMD
• Vanessa Serrano
• Sexy-N-Lace
• Amira Shafey

• Clinical Social Worker in Acworth, GA
• Providers in Acworth, GA by specialty
• Clinical Social Worker in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 12, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.