Individual provider Active NPI

Michael Dean Norman Jr.

  • Clinical Social Worker
  • Tifton, GA
National Provider Identifier
1528884418
Registry record updated Nov 25, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
CSW004207 Issued in GA
Practice address
601 46TH St E
Tifton, GA 31794-1558
Phone
(229) 848-0190
NPI assigned
Nov 25, 2024
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 25, 2024

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 CSW004207 GA Primary

Addresses

Primary practice location

601 46TH St E
Tifton, GA 31794-1558

Mailing address

601 46TH St E
Tifton, GA 31794-1558
Phone (229) 848-0190

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
I20250127000207 GA Practitioner - Clinical Social Worker 7113456856 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Ar Psychiatric and Counseling Center LLCGroup PAC ID 9335326941, 11 clinicians

Practice addresses (Care Compare)

3312 N Oak St Ext
BLDG D
Valdosta, GA 31605-1066
Phone (229) 244-2030

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
CSW004207GAMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Ar Psychiatric & Counseling Center LLC CurrentSince Jan 1, 2025 Accepting new patients

Locations

2014 Pineview Ave
Tifton, GA 31794
Phone (229) 387-8878

3312 N Oak Street Ext
Bldg D
Valdosta, GA 31605
Phone (229) 244-2030

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": "1732492800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1732492800000",
    "number": "1528884418",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "601 46TH ST E",
            "city": "TIFTON",
            "state": "GA",
            "postal_code": "317941558",
            "telephone_number": "229-848-0190"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "601 46TH ST E",
            "city": "TIFTON",
            "state": "GA",
            "postal_code": "317941558",
            "telephone_number": "229-848-0190"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NORMAN",
        "first_name": "MICHAEL",
        "middle_name": "DEAN",
        "name_prefix": "Mr.",
        "name_suffix": "Jr.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2024-11-25",
        "last_updated": "2024-11-25",
        "certification_date": "2024-11-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "GA",
            "license": "CSW004207",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tifton, GA

Sources for this page

Verify at the official NPI Registry.