Individual provider Active NPI

Gerald Rhett, LCSW, ICADC, ICCS

  • Clinical Social Worker
  • Atlanta, GA
National Provider Identifier
1497028427
Registry record updated Dec 14, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
CSW004673 Issued in GA
Practice address
6291 Shell Dr SW
Atlanta, GA 30331-9420
Phone
(404) 523-4599
Fax
(404) 586-0645
NPI assigned
Feb 22, 2012
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 14, 2012

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X CSW004673 GA Primary
Addiction (Substance Use Disorder) Counselor 101YA0400X CERTIFICATE #227 GA

Addresses

Primary practice location

6291 Shell Dr SW
Atlanta, GA 30331-9420

Mailing address

6291 Shell Dr SW
Atlanta, GA 30331-9420
Phone (404) 523-4599

Other identifiers 2

IdentifierTypeStateIssuer
CSW004673OtherGASECRETARY OF STATE, GEORGIA COMPOSITE BOARD
112681OtherGAICADC INTERNATIONALLY CERTIFIED ALCOHOL AND DRUG COUNSELOR

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
I20120426000090 GA Practitioner - Clinical Social Worker 8325200082 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2009
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

8335 A Office Park Dr
Douglasville, GA 30134-6937
Phone (678) 324-0476

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
CERTIFICATE #227GAMDAddiction (Substance Use Disorder) Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Recovery Unlimited LLC Addiction (Substance Use Disorder) CurrentSince Jul 15, 2016 Accepting new patients

Locations

8335 Office Park Dr
#A
Douglasville, GA 30134
Phone (678) 324-0476

8335 Office Park Dr
Douglasville, GA 30134
Phone (678) 324-0476

8335 Office Park Dr
Ste A
Douglasville, GA 30134
Phone (678) 324-0476

5960 Crooked Creek Rd
Ste 140F
Peachtree Corners, GA 30092
Phone (404) 664-4517

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": "1329868800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1355443200000",
    "number": "1497028427",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6291 SHELL DR SW",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303319420",
            "telephone_number": "404-523-4599",
            "fax_number": "404-586-0645"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6291 SHELL DR SW",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303319420",
            "telephone_number": "404-523-4599",
            "fax_number": "404-586-0645"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RHETT",
        "first_name": "GERALD",
        "credential": "LCSW, ICADC, ICCS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2012-02-22",
        "last_updated": "2012-12-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "GA",
            "license": "CSW004673",
            "primary": true
        },
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "GA",
            "license": "CERTIFICATE #227",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "SECRETARY OF STATE, GEORGIA COMPOSITE BOARD",
            "identifier": "CSW004673",
            "state": "GA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ICADC INTERNATIONALLY CERTIFIED ALCOHOL AND DRUG COUNSELOR",
            "identifier": "112681",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Atlanta, GA

Sources for this page

Verify at the official NPI Registry.