Tangie Martin Macon, LCSW, PIP

Primary specialty

Social WorkerTaxonomy code 104100000X

License

1799G Issued in AL

Practice address

700 19TH St S
Birmingham, AL 35233-1927

Phone

(205) 933-8101

Fax

(205) 558-4783

NPI assigned

Jan 8, 2010

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• Willow Grace Wellness Center LLC

  • Clinical Social Worker
  • Vestavia Hills, AL
  • NPI 1467020891
  NPD Authorized official

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

{
    "created_epoch": "1262908800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1354579200000",
    "number": "1598095895",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "700 19TH ST S",
            "city": "BIRMINGHAM",
            "state": "AL",
            "postal_code": "352331927",
            "telephone_number": "205-933-8101",
            "fax_number": "205-558-4758"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "700 19TH ST S",
            "city": "BIRMINGHAM",
            "state": "AL",
            "postal_code": "352331927",
            "telephone_number": "205-933-8101",
            "fax_number": "205-558-4783"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MACON",
        "first_name": "TANGIE",
        "middle_name": "MARTIN",
        "name_prefix": "Mrs.",
        "credential": "LCSW, PIP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-01-08",
        "last_updated": "2012-12-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "AL",
            "license": "1799G",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Amanda Mackinaw, PTA
• Alexander C Mackinnon Jr., M.D., PH.D.
• William A.H. Maclean, M.D.
• Loyer Macleod, RBT
• Jeanine S Maclin, M.D.
• Michael Macwilliam, D.M.D.
• Jayakrishna S Madabushi, MBBS
• Suman Madan
• Raena Maday, MA, LPC
• Maegan Madden

• Social Worker in Birmingham, AL
• Providers in Birmingham, AL by specialty
• Social Worker in Alabama

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 4, 2012; 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.