Individual provider Active NPI

Shirley Gale White, L.C.S.W.

  • Clinical Social Worker
  • Marietta, GA
National Provider Identifier
1447477807
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
001365 Issued in GA
Practice address
2029 Kramer Way
Marietta, GA 30062-5476
Phone
(678) 560-1487
NPI assigned
Apr 19, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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 001365 GA Primary

Addresses

Primary practice location

2029 Kramer Way
Marietta, GA 30062-5476

Mailing address

2029 Kramer Way
Marietta, GA 30062-5476
Phone (678) 560-1487

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
1365GAMDAddiction (Substance Use Disorder) Counselor
001365GAMDObstetrics & Gynecology Physician

NPI Registry JSON

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

{
    "created_epoch": "1176940800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1447477807",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2029 KRAMER WAY",
            "city": "MARIETTA",
            "state": "GA",
            "postal_code": "300625476",
            "telephone_number": "678-560-1487"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2029 KRAMER WAY",
            "city": "MARIETTA",
            "state": "GA",
            "postal_code": "300625476",
            "telephone_number": "678-560-1487"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WHITE",
        "first_name": "SHIRLEY",
        "middle_name": "GALE",
        "name_prefix": "Ms.",
        "credential": "L.C.S.W.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-04-19",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "GA",
            "license": "001365",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Marietta, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.