Active NPI
Samia Denise Coaxum, MSW
- Social Worker
- Douglasville, GA
National Provider Identifier
1497486898
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Social Worker
- Practice address
- 3915 Brookhollow Dr
Douglasville, GA 30135-2099 - Phone
- (917) 304-0489
- NPI assigned
- Jun 17, 2022
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Social Worker | 104100000X | GA | Primary |
Addresses
Primary practice location
3915 Brookhollow Dr
Douglasville, GA 30135-2099
Mailing address
3915 Brookhollow Dr
Douglasville, GA 30135-2099
Phone (917) 304-0489
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1655424000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1655424000000",
"number": "1497486898",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3915 BROOKHOLLOW DR",
"city": "DOUGLASVILLE",
"state": "GA",
"postal_code": "301352099",
"telephone_number": "917-304-0489"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3915 BROOKHOLLOW DR",
"city": "DOUGLASVILLE",
"state": "GA",
"postal_code": "301352099",
"telephone_number": "917-304-0489"
}
],
"practiceLocations": [],
"basic": {
"last_name": "COAXUM",
"first_name": "SAMIA",
"middle_name": "DENISE",
"credential": "MSW",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2022-06-17",
"last_updated": "2022-06-17",
"certification_date": "2022-06-17",
"status": "A"
},
"taxonomies": [
{
"code": "104100000X",
"taxonomy_group": "",
"desc": "Social Worker",
"state": "GA",
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Douglasville, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 17, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.