Individual provider Active NPI

Kaila S. Tang, LCSW

  • Clinical Social Worker
  • Brookhaven, GA
National Provider Identifier
1427684273
Registry record updated Nov 8, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
CSW008798 Issued in GA
Practice address
2801 Buford Hwy NE Ste 503
Brookhaven, GA 30329-2137
Phone
(678) 653-6166
NPI assigned
Mar 12, 2020
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 8, 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 CSW008798 GA Primary

Addresses

Primary practice location

2801 Buford Hwy NE Ste 503
Brookhaven, GA 30329-2137

Mailing address

2801 Buford Hwy NE Ste 503
Brookhaven, GA 30329-2137

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Opted out of Medicare
Yes, effective May 15, 2024 through May 15, 2028

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
CSW008798GAMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1583971200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1699401600000",
    "number": "1427684273",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2801 BUFORD HWY NE STE 503",
            "city": "BROOKHAVEN",
            "state": "GA",
            "postal_code": "303292137"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2801 BUFORD HWY NE STE 503",
            "city": "BROOKHAVEN",
            "state": "GA",
            "postal_code": "303292137",
            "telephone_number": "678-653-6166"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TANG",
        "first_name": "KAILA",
        "middle_name": "S.",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-03-12",
        "last_updated": "2023-11-08",
        "certification_date": "2023-11-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "GA",
            "license": "CSW008798",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brookhaven, GA

Sources for this page

Verify at the official NPI Registry.