Individual provider Active NPI

Ilene Babs Federman, MSSW

  • Clinical Social Worker
  • Woodstock, GA
National Provider Identifier
1477768604
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
CSW001454 Issued in GA
Practice address
242 Creekstone RDG
Woodstock, GA 30188-3732
Phone
(678) 445-4184
Fax
(678) 445-5146
NPI assigned
May 11, 2007
Last updated
Jul 8, 2007By the provider in NPPES
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 CSW001454 GA Primary

Addresses

Primary practice location

242 Creekstone RDG
Woodstock, GA 30188-3732

Mailing address

7402 Saint Charles SQ
Roswell, GA 30075-3873
Phone (770) 552-4018

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
CSW001454GAMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Senior Psych Solutions Corp Clinical Past Accepting new patients
Federman Counseling & Psychotherapy, Inc Clinical Past Accepting new patients

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1178841600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1477768604",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7402 SAINT CHARLES SQ",
            "city": "ROSWELL",
            "state": "GA",
            "postal_code": "300753873",
            "telephone_number": "770-552-4018"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "242 CREEKSTONE RDG",
            "city": "WOODSTOCK",
            "state": "GA",
            "postal_code": "301883732",
            "telephone_number": "678-445-4184",
            "fax_number": "678-445-5146"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FEDERMAN",
        "first_name": "ILENE",
        "middle_name": "BABS",
        "name_prefix": "Miss",
        "credential": "MSSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-05-11",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "GA",
            "license": "CSW001454",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Woodstock, 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.