NPIMap

Organization Active NPI

Creating Conscious Connections, LLC

  • School Social Worker
  • Atlanta, GA
National Provider Identifier
1508327305
Registry record updated Dec 4, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
School Social WorkerTaxonomy code 1041S0200X
Legal business name
CREATING CONSCIOUS CONNECTIONS, LLC
Practice address
1827 Powers Ferry Road
Building 21 - Suite 350
Atlanta, GA 30339
Phone
(770) 956-1056
NPI assigned
Mar 26, 2019
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 4, 2020

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

Authorized official

Name
Mr. Robert Mathis, LCSWNPI 1558498154
Title
Owner
Phone
(770) 956-1056

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
School Social WorkerGroup: 193400000X SINGLE SPECIALTY GROUP 1041S0200X Primary

Addresses

Primary practice location

1827 Powers Ferry Road
Building 21 - Suite 350
Atlanta, GA 30339

Mailing address

3315 South Cobb Drive
Suite 700 #813386
Smyrna, GA 30080
Phone (770) 956-1056

National Provider Directory

National Provider Directory

Locations

3315 S Cobb Dr SE
Ste 700
Smyrna, GA 30080

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1553558400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1607040000000",
    "number": "1508327305",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3315 SOUTH COBB DRIVE",
            "address_2": "SUITE 700 #813386",
            "city": "SMYRNA",
            "state": "GA",
            "postal_code": "30080",
            "telephone_number": "770-956-1056"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1827 POWERS FERRY ROAD",
            "address_2": "BUILDING 21 - SUITE 350",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "30339",
            "telephone_number": "770-956-1056"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CREATING CONSCIOUS CONNECTIONS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-03-26",
        "last_updated": "2020-12-04",
        "certification_date": "2020-12-04",
        "status": "A",
        "authorized_official_last_name": "MATHIS",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "770-956-1056",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "1041S0200X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Social Worker, School",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Atlanta, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 4, 2020; 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.