Individual provider Active NPI

Andrea Brock

  • Clinical Social Worker
  • Decatur, GA
National Provider Identifier
1528504784
Registry record updated Jan 12, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
CSW005567 Issued in GA
Practice address
445 Winn Way
Decatur, GA 30030-1707
Phone
(404) 294-3745
NPI assigned
Jan 12, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 12, 2017

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 CSW005567 GA Primary

Addresses

Primary practice location

445 Winn Way
Decatur, GA 30030-1707

Mailing address

445 Winn Way
Decatur, GA 30030-1707
Phone (404) 294-3745

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
I20180813002603 GA Practitioner - Clinical Social Worker 7012265796 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Thrive Counseling LLCGroup PAC ID 0749458420, 1,187 clinicians

Practice addresses (Care Compare)

2713 Charles Hardy Pkwy
Suite 223
Dallas, GA 30157-9470
Phone (855) 284-7483

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
CSW005567GAMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Thrive Counseling LLC CurrentSince Feb 6, 2023 Accepting new patients

Locations

2713 Charles Hardy Pkwy
Ste 223
Dallas, GA 30157
Phone (678) 324-7021

8800 Roswell Rd
Ste A135
Sandy Springs, GA 30350
Phone (617) 395-5806

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": "1484179200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1484179200000",
    "number": "1528504784",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "445 WINN WAY",
            "city": "DECATUR",
            "state": "GA",
            "postal_code": "300301707",
            "telephone_number": "404-294-3745"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "445 WINN WAY",
            "city": "DECATUR",
            "state": "GA",
            "postal_code": "300301707",
            "telephone_number": "404-294-3745"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BROCK",
        "first_name": "ANDREA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-01-12",
        "last_updated": "2017-01-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "GA",
            "license": "CSW005567",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Decatur, GA

Sources for this page

Verify at the official NPI Registry.