Mary Kathleen West LCSW, Inc

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

CSW1362 Issued in GA

Legal business name

MARY KATHLEEN WEST LCSW, INC

Practice address

201 Cove Rd
Jasper, GA 30143

Phone

(706) 253-9515

Fax

(706) 253-9516

NPI assigned

Oct 29, 2009

Organization subpart

No

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

Authorized official

Name

Mary Kathleen West, LCSWNPI 1134193741

Title

Owner

Phone

(706) 253-9515

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in GA

Enrollment records 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Mary Kathleen West, LCSW, INC

  • Clinical Social Worker
  • Jasper, GA
  • NPI 1134193741
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1256774400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1602201600000",
    "number": "1447586268",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "201 COVE RD",
            "city": "JASPER",
            "state": "GA",
            "postal_code": "30143",
            "telephone_number": "706-253-9515",
            "fax_number": "706-253-9516"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "201 COVE RD",
            "city": "JASPER",
            "state": "GA",
            "postal_code": "30143",
            "telephone_number": "706-253-9515",
            "fax_number": "706-253-9516"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MARY KATHLEEN WEST LCSW, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-10-29",
        "last_updated": "2020-10-09",
        "certification_date": "2020-10-09",
        "status": "A",
        "authorized_official_last_name": "WEST",
        "authorized_official_first_name": "MARY",
        "authorized_official_middle_name": "KATHLEEN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "706-253-9515",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Social Worker, Clinical",
            "state": "GA",
            "license": "CSW1362",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "939149656A",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Khawaja R Mahmood, M.D.
• Patrick S Malone, DPM
• Karl Mareth, MD
• Kimberly Lisle Martin, LPC
• Victoria Martin
• Scott Masson, D.O.
• Moiz Vasim Master, M.D.
• Mastercare Medical Center
• Abraham Mathai, M.D., PH.D.
• Matthew W Camp Ophthalmology LLC

• Clinical Social Worker in Jasper, GA
• Providers in Jasper, 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 Oct 9, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.