Individual provider Active NPI

Melissa Guthrie-Thomas, LCSW

  • Clinical Social Worker
  • Waycross, GA
National Provider Identifier
1578864997
Registry record updated Nov 17, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
CSW004056 Issued in TX
Practice address
1007 Mary St
Waycross, GA 31503-3823
Phone
(912) 449-7100
NPI assigned
Nov 17, 2010
Last updated
Nov 17, 2010By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 17, 2010

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 CSW004056 TX Primary

Addresses

Primary practice location

1007 Mary St
Waycross, GA 31503-3823

Mailing address

1007 Mary St
Waycross, GA 31503-3823

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
I20101216000323 GA Practitioner - Clinical Social Worker 4082802129 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1985
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Unison Behavioral HealthGroup PAC ID 7517852247, 19 clinicians

Practice addresses (Care Compare)

1005 Shirley Ave
Douglas, GA 31533-2123
Phone (912) 389-4188

1007 Mary St
Waycross, GA 31503-3823
Phone (912) 285-6142

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
CSW004056TXMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Unison Behavioral Health CurrentSince Nov 1, 2010 Accepting new patients
Unison Behavioral Health CurrentSince Nov 1, 2010 Accepting new patients

Locations

1007 Mary St
Waycross, GA 31503
Phone (912) 284-2547

Organizations & group practices 2

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": "1289952000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1289952000000",
    "number": "1578864997",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1007 MARY ST",
            "city": "WAYCROSS",
            "state": "GA",
            "postal_code": "315033823"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1007 MARY ST",
            "city": "WAYCROSS",
            "state": "GA",
            "postal_code": "315033823",
            "telephone_number": "912-449-7100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GUTHRIE-THOMAS",
        "first_name": "MELISSA",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-11-17",
        "last_updated": "2010-11-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "TX",
            "license": "CSW004056",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Waycross, GA

Sources for this page

Verify at the official NPI Registry.