Individual provider Active NPI

Jonita Leandra McKinney

  • Clinical Social Worker
  • Lawrenceville, GA
National Provider Identifier
1487226569
Registry record updated Dec 2, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
Practice address
175 Langley Dr Ste E1
Lawrenceville, GA 30046-6952
Phone
(470) 219-1472
NPI assigned
Jul 16, 2021
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 2, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social WorkerGroup: 193400000X SINGLE SPECIALTY GROUP 1041C0700X Primary

Addresses

Primary practice location

175 Langley Dr Ste E1
Lawrenceville, GA 30046-6952

Mailing address

175 Langley Dr Ste E1
Lawrenceville, GA 30046-6952
Phone (470) 219-1472

Electronic endpoints 2

TypeEndpointUseAffiliation
CONNECT URL @refiningfireatl.org
CONNECT URL @outlook.com

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)
Not enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Refining Perceptions Clinical Current Accepting new patients
Phoenix Pathways LLC. Clinical Current Accepting new patients

Locations

175 Langley Dr
Ste E1
Lawrenceville, GA 30046
Phone (470) 219-1472

279 W Crogan St
Lawrenceville, GA 30046
Phone (404) 396-4417

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1626393600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1733097600000",
    "number": "1487226569",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "175 LANGLEY DR STE E1",
            "city": "LAWRENCEVILLE",
            "state": "GA",
            "postal_code": "300466952",
            "telephone_number": "470-219-1472"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "175 LANGLEY DR STE E1",
            "city": "LAWRENCEVILLE",
            "state": "GA",
            "postal_code": "300466952",
            "telephone_number": "470-219-1472"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCKINNEY",
        "first_name": "JONITA",
        "middle_name": "LEANDRA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-07-16",
        "last_updated": "2024-12-02",
        "certification_date": "2024-12-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "@refiningfireatl.org",
            "affiliation": "N",
            "address_1": "175 Langley Dr Ste E1",
            "city": "Lawrenceville",
            "state": "GA",
            "country_code": "US",
            "postal_code": "300466952",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "@outlook.com",
            "affiliation": "N",
            "address_1": "175 Langley Dr Ste E1",
            "city": "Lawrenceville",
            "state": "GA",
            "country_code": "US",
            "postal_code": "300466952",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Lawrenceville, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 2, 2024; 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.