Active NPI
Mary Kate Ulshafer, LCSW
- Clinical Social Worker
- Atlanta, GA
National Provider Identifier
1396418711
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- CSW009018
- Practice address
- 2999 Piedmont Rd NE Ste 100
Atlanta, GA 30305-2792 - Phone
- (678) 679-8404
- NPI assigned
- Jul 30, 2021
- Sex
- Female
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | GA | ||
| Clinical Social Worker | 1041C0700X | CSW009018 | GA | Primary |
Addresses
Primary practice location
2999 Piedmont Rd NE Ste 100
Atlanta, GA 30305-2792
Mailing address
1469 Pine St NW Unit a
Atlanta, GA 30309-2249
Phone (478) 957-3831
Other practice location 1
1017 Fayetteville Rd SE
Atlanta, GA 30316-2932
Phone (770) 722-0080
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
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Chris 180, Inc. | Past | Accepting new patients |
Organizations & group practices 2
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.
-
- Community/Behavioral Health Agency
- Atlanta, GA
- NPI 1134257827
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1627603200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1718841600000",
"number": "1396418711",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1469 PINE ST NW UNIT A",
"city": "ATLANTA",
"state": "GA",
"postal_code": "303092249",
"telephone_number": "478-957-3831"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2999 PIEDMONT RD NE STE 100",
"city": "ATLANTA",
"state": "GA",
"postal_code": "303052792",
"telephone_number": "678-679-8404"
}
],
"practiceLocations": [
{
"address_1": "1017 Fayetteville Rd SE",
"address_purpose": "LOCATION",
"city": "Atlanta",
"state": "GA",
"postal_code": "303162932",
"country_code": "US",
"telephone_number": "770-722-0080",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "ULSHAFER",
"first_name": "MARY",
"middle_name": "KATE",
"credential": "LCSW",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2021-07-30",
"last_updated": "2024-06-20",
"certification_date": "2024-06-20",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "GA",
"license": null,
"primary": false
},
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "GA",
"license": "CSW009018",
"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 Jun 20, 2024; 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.