Individual provider Active NPI

Jamia Poole, LMSW, LISW, LCSW

  • Clinical Social Worker
  • Peachtree Corners, GA
National Provider Identifier
1497147649
Registry record updated Feb 3, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
CSW007249 Issued in GA
Practice address
5030 Riverthur PL
Peachtree Corners, GA 30096-2930
Phone
(470) 576-4129
NPI assigned
Feb 25, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 3, 2025

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 11058 SC
Clinical Social Worker 1041C0700X CSW007249 GA Primary

Addresses

Primary practice location

5030 Riverthur PL
Peachtree Corners, GA 30096-2930

Mailing address

614 Plantation Trace Dr
Duluth, GA 30096-1608
Phone (423) 220-0240

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
I20201106000135 GA Practitioner - Clinical Social Worker 2860802667 Practice locations: Peachtree Corners, GA

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

5030 Riverthur PL
Peachtree Corners, GA 30096-2930
Phone (423) 220-0240

Merit-based Incentive Payment System (MIPS)

Final score
49.38 of 100Reported as group
Quality
4.35
Promoting interoperability
0
Improvement activities
40
Cost
76.92

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
CSW007249GAMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Renew Serenity Wellness Center Mental Health Current Accepting new patients
Modern Wellness Collective Mental Health CurrentSince Feb 9, 2025 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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1424822400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1738540800000",
    "number": "1497147649",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "614 PLANTATION TRACE DR",
            "city": "DULUTH",
            "state": "GA",
            "postal_code": "300961608",
            "telephone_number": "423-220-0240"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5030 RIVERTHUR PL",
            "city": "PEACHTREE CORNERS",
            "state": "GA",
            "postal_code": "300962930",
            "telephone_number": "470-576-4129"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "POOLE",
        "first_name": "JAMIA",
        "credential": "LMSW, LISW, LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-02-25",
        "last_updated": "2025-02-03",
        "certification_date": "2025-02-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "SC",
            "license": "11058",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "GA",
            "license": "CSW007249",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Peachtree Corners, GA

Sources for this page

Verify at the official NPI Registry.