Individual provider Active NPI

Jane Faulk Hardee, LCSW

  • Clinical Social Worker
  • Macon, GA
National Provider Identifier
1407943152
Registry record updated Oct 29, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
CSW000304 Issued in GA
Practice address
655 First Street
Macon, GA 31201
Phone
(478) 301-5930
Fax
(478) 301-5932
NPI assigned
Oct 6, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 29, 2014

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X CSW000304 GA Primary
Marriage & Family Therapist 106H00000X MFT000169 GA

Addresses

Primary practice location

655 First Street
Macon, GA 31201

Mailing address

PO Box 4947
Macon, GA 31208-4947
Phone (478) 301-4111

Other identifiers 2

IdentifierTypeStateIssuer
000748811AMedicaidGA
800007277OtherGARAILROAD MEDICARE

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
MFT000169GAMDMarriage & Family Therapist

NPI Registry JSON

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

{
    "created_epoch": "1160092800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1414540800000",
    "number": "1407943152",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 4947",
            "city": "MACON",
            "state": "GA",
            "postal_code": "312084947",
            "telephone_number": "478-301-4111",
            "fax_number": "478-301-2272"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "655 FIRST STREET",
            "city": "MACON",
            "state": "GA",
            "postal_code": "31201",
            "telephone_number": "478-301-5930",
            "fax_number": "478-301-5932"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HARDEE",
        "first_name": "JANE",
        "middle_name": "FAULK",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-06",
        "last_updated": "2014-10-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "GA",
            "license": "CSW000304",
            "primary": true
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "GA",
            "license": "MFT000169",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000748811A",
            "state": "GA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "800007277",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Macon, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 29, 2014; 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.