Individual provider Active NPI

Jordan Abernathy-Cornelius, LCSW

  • Clinical Social Worker
  • Alpharetta, GA
National Provider Identifier
1396488433
Registry record updated Jan 18, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
Practice address
11720 Amberpark Dr Ste 160
Alpharetta, GA 30009-2271
Phone
(470) 695-0024
NPI assigned
Apr 17, 2022
Last updated
Jan 18, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 18, 2023

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 GA Primary

Addresses

Primary practice location

11720 Amberpark Dr Ste 160
Alpharetta, GA 30009-2271

Mailing address

11720 Amberpark Dr Ste 160
Alpharetta, GA 30009-2271
Phone (470) 695-0024

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

Practice roles

OrganizationSpecialtyStatusNew patients
Life's a Journey Counseling Services, LLC CurrentSince Aug 1, 2022 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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1650153600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1674000000000",
    "number": "1396488433",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11720 AMBERPARK DR STE 160",
            "city": "ALPHARETTA",
            "state": "GA",
            "postal_code": "300092271",
            "telephone_number": "470-695-0024"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11720 AMBERPARK DR STE 160",
            "city": "ALPHARETTA",
            "state": "GA",
            "postal_code": "300092271",
            "telephone_number": "470-695-0024"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ABERNATHY-CORNELIUS",
        "first_name": "JORDAN",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-04-17",
        "last_updated": "2023-01-18",
        "certification_date": "2023-01-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "GA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Alpharetta, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 18, 2023; 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.