Carly Ann Sackellares, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

CSW010402 Issued in GA

Practice address

104 Pilgrim Village Dr Ste 300
Cumming, GA 30040-9232

Phone

(678) 740-3022

NPI assigned

Jul 6, 2026

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1783296000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783296000000",
    "number": "1417875758",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6038 GABLES LN APT 6038",
            "city": "SANDY SPRINGS",
            "state": "GA",
            "postal_code": "303505036",
            "telephone_number": "770-846-0128"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "104 PILGRIM VILLAGE DR STE 300",
            "city": "CUMMING",
            "state": "GA",
            "postal_code": "300409232",
            "telephone_number": "678-740-3022"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SACKELLARES",
        "first_name": "CARLY",
        "middle_name": "ANN",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2026-07-06",
        "last_updated": "2026-07-06",
        "certification_date": "2026-07-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Social Worker, Clinical",
            "state": "GA",
            "license": "CSW010402",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Clinical Social Worker in Cumming, GA
• Providers in Cumming, 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 Jul 6, 2026; 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.