Individual provider Active NPI

Richard Lee Phillips, LCSW

  • Clinical Social Worker
  • Monroe, GA
National Provider Identifier
1487819207
Registry record updated Jan 26, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
CSW003752 Issued in GA
Practice address
204 W Spring St
Monroe, GA 30655-1914
Phone
(678) 509-7178
Fax
(866) 734-7631
NPI assigned
Jul 21, 2008
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 26, 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 Worker 1041C0700X CSW003752 GA Primary

Addresses

Primary practice location

204 W Spring St
Monroe, GA 30655-1914

Mailing address

728 Overlook CRST
Monroe, GA 30655-8476
Phone (770) 267-0706

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210719002105 GA Practitioner - Clinical Social Worker 5991108607 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Creative Center for Wellness, IncorporatedGroup PAC ID 3274888946, 3 clinicians

Practice addresses (Care Compare)

129 Lee Byrd Rd
Loganville, GA 30052-2310
Phone (770) 599-7508

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Creative Center for Wellness, Incorporated Clinical CurrentSince Mar 8, 2021 Accepting new patients

Locations

129 Lee Byrd Rd
Loganville, GA 30052
Phone (770) 599-7508

204 W Spring St
Monroe, GA 30655
Phone (707) 599-7508

Organizations & group practices 1

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": "1216598400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1706227200000",
    "number": "1487819207",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "728 OVERLOOK CRST",
            "city": "MONROE",
            "state": "GA",
            "postal_code": "306558476",
            "telephone_number": "770-267-0706"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "204 W SPRING ST",
            "city": "MONROE",
            "state": "GA",
            "postal_code": "306551914",
            "telephone_number": "678-509-7178",
            "fax_number": "866-734-7631"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PHILLIPS",
        "first_name": "RICHARD",
        "middle_name": "LEE",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-07-21",
        "last_updated": "2024-01-26",
        "certification_date": "2024-01-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "GA",
            "license": "CSW003752",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Monroe, GA

Sources for this page

Verify at the official NPI Registry.