Individual provider Active NPI

Jill Allweiss, LCSW

  • Clinical Social Worker
  • Marietta, GA
National Provider Identifier
1386845923
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
CSW001787 Issued in GA
Practice address
122 Cherry St NE
Marietta, GA 30060-7206
Phone
(770) 434-5914
Fax
(770) 422-2302
NPI assigned
May 30, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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 CSW001787 GA Primary

Addresses

Primary practice location

122 Cherry St NE
Marietta, GA 30060-7206

Mailing address

2080 Clinton Dr
Marietta, GA 30062-5848
Phone (770) 434-5914

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20130723000251 GA Practitioner - Clinical Social Worker 1658512348 Practice locations: Marietta, GA

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1981
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

122 Cherry St NE
Marietta, GA 30060-7206
Phone (770) 434-5914

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
CSW001787GAMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1180483200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1386845923",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2080 CLINTON DR",
            "city": "MARIETTA",
            "state": "GA",
            "postal_code": "300625848",
            "telephone_number": "770-434-5914",
            "fax_number": "770-422-2302"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "122 CHERRY ST NE",
            "city": "MARIETTA",
            "state": "GA",
            "postal_code": "300607206",
            "telephone_number": "770-434-5914",
            "fax_number": "770-422-2302"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ALLWEISS",
        "first_name": "JILL",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-05-30",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "GA",
            "license": "CSW001787",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Marietta, GA

Sources for this page

Verify at the official NPI Registry.