Individual provider Active NPI

Moniek Shanell Garside, LCSW, MBA

  • Clinical Social Worker
  • Atlanta, GA
National Provider Identifier
1568904456
Registry record updated Jun 2, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
CSW005281 Issued in GA
Practice address
2751 Buford Hwy NE Ste 700
Atlanta, GA 30324-5510
Phone
(404) 807-2770
Fax
(404) 829-2400
NPI assigned
Nov 9, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 2, 2021

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 CSW005281 GA Primary

Addresses

Primary practice location

2751 Buford Hwy NE Ste 700
Atlanta, GA 30324-5510

Mailing address

PO Box 871296
Stone Mountain, GA 30087-0033
Phone (404) 807-2770

Other practice location 1

1364 Clifton Rd NE
Atlanta, GA 30322-1059
Phone (404) 712-9794

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)
Enrolled
Credentials
Master of Business Administration

State licenses

LicenseStateTypeSpecialty
CSW005281GAMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1478649600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1622592000000",
    "number": "1568904456",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 871296",
            "city": "STONE MOUNTAIN",
            "state": "GA",
            "postal_code": "300870033",
            "telephone_number": "404-807-2770",
            "fax_number": "404-829-2400"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2751 BUFORD HWY NE STE 700",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303245510",
            "telephone_number": "404-807-2770",
            "fax_number": "404-829-2400"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1364 Clifton Rd NE",
            "address_purpose": "LOCATION",
            "city": "Atlanta",
            "state": "GA",
            "postal_code": "303221059",
            "country_code": "US",
            "telephone_number": "404-712-9794",
            "fax_number": "404-727-1709",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GARSIDE",
        "first_name": "MONIEK",
        "middle_name": "SHANELL",
        "name_prefix": "Mrs.",
        "credential": "LCSW, MBA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-11-09",
        "last_updated": "2021-06-02",
        "certification_date": "2021-06-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "GA",
            "license": "CSW005281",
            "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 Jun 2, 2021; 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.