Individual provider Active NPI

Johntavious Jones, LCSW

  • Social Worker
  • Griffin, GA
National Provider Identifier
1487279097
Registry record updated Jul 24, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
License
CSW009088 Issued in GA
Practice address
415 E Poplar St Ste C
Griffin, GA 30224-3403
Phone
(678) 408-0109
NPI assigned
Jun 9, 2020
Last updated
Jul 24, 2026By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 24, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X CSW009088 GA Primary

Addresses

Primary practice location

415 E Poplar St Ste C
Griffin, GA 30224-3403

Mailing address

415 E Poplar St Ste C
Griffin, GA 30224-3403

Other practice location 1

3155 Mill St NE
Covington, GA 30014-2542
Phone (678) 712-6520

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

State licenses

LicenseStateTypeSpecialty
CSW009088GAMDSocial Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Ceed Community Enrichment, LLC CurrentSince May 7, 2024 Accepting new patients
Southeastern Psychological Associates, Inc CurrentSince Dec 1, 2023 Accepting new patients
Discovery Counseling and Assessment Center, LLC PastSince Dec 1, 2022 Accepting new patients

Locations

3155 Mill St NE
Covington, GA 30014
Phone (678) 712-6520

228 E Poplar St
Ste C
Griffin, GA 30224
Phone (678) 408-0109

415 E Poplar St
Ste C
Griffin, GA 30224

Organizations & group practices 3

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": "1591660800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1784851200000",
    "number": "1487279097",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "415 E POPLAR ST STE C",
            "city": "GRIFFIN",
            "state": "GA",
            "postal_code": "302243403"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "415 E POPLAR ST STE C",
            "city": "GRIFFIN",
            "state": "GA",
            "postal_code": "302243403",
            "telephone_number": "678-408-0109"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3155 Mill St NE",
            "address_purpose": "LOCATION",
            "city": "Covington",
            "state": "GA",
            "postal_code": "300142542",
            "country_code": "US",
            "telephone_number": "678-712-6520",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JONES",
        "first_name": "JOHNTAVIOUS",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-06-09",
        "last_updated": "2026-07-24",
        "certification_date": "2026-07-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "GA",
            "license": "CSW009088",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Griffin, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 24, 2026; 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.