Individual provider Active NPI

Judy Martin Trexler, LCSW

  • Clinical Social Worker
  • Valdosta, GA
National Provider Identifier
1568654440
Registry record updated Jan 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
1308 Issued in GA
Practice address
109 W Jane St
Valdosta, GA 31601-3950
Phone
(229) 671-1461
Fax
(229) 671-1471
NPI assigned
Aug 14, 2007
Last updated
Jan 22, 2020By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 22, 2020

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 1308 GA Primary

Addresses

Primary practice location

109 W Jane St
Valdosta, GA 31601-3950

Mailing address

PO Box 6011
Valdosta, GA 31603-6011
Phone (229) 671-1461

Other identifiers 1

IdentifierTypeStateIssuer
003109170CMedicaidGA

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
I20091210000415 GA Practitioner - Clinical Social Worker 1557401270 Practice locations: Lake Park, GA; Valdosta, GA

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
University of Tennessee, HSC, College of Medicine, 1983
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

518 Jackson Cir
Lake Park, GA 31636-4926
Phone (229) 671-1461

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1308GAMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Ar Psychiatric & Counseling Center LLC PastSince Jul 1, 2011 Accepting new patients
Senior Psych Solutions Corp Clinical Past Accepting new patients
Center for Personal and Family Growth LLC Clinical PastSince Dec 18, 2013 Accepting new patients

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1187049600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1579651200000",
    "number": "1568654440",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 6011",
            "city": "VALDOSTA",
            "state": "GA",
            "postal_code": "316036011",
            "telephone_number": "229-671-1461",
            "fax_number": "229-671-1471"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "109 W JANE ST",
            "city": "VALDOSTA",
            "state": "GA",
            "postal_code": "316013950",
            "telephone_number": "229-671-1461",
            "fax_number": "229-671-1471"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TREXLER",
        "first_name": "JUDY",
        "middle_name": "MARTIN",
        "name_prefix": "Mrs.",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-08-14",
        "last_updated": "2020-01-22",
        "certification_date": "2020-01-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "GA",
            "license": "1308",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "003109170C",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Valdosta, GA

Sources for this page

Verify at the official NPI Registry.