Active NPI
Corey Allen Mungin, LCSW
- Clinical Social Worker
- Kathleen, GA
National Provider Identifier
1598321069
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- CSW006456
- Practice address
- 328 Cambrian Dr
Kathleen, GA 31047-4516 - Phone
- (678) 313-2815
- NPI assigned
- May 10, 2019
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | CSW006456 | GA | Primary |
Addresses
Primary practice location
328 Cambrian Dr
Kathleen, GA 31047-4516
Mailing address
328 Cambrian Dr
Kathleen, GA 31047-4516
Phone (678) 313-2815
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| CSW006456 | GA | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1557446400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1557446400000",
"number": "1598321069",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "328 CAMBRIAN DR",
"city": "KATHLEEN",
"state": "GA",
"postal_code": "310474516",
"telephone_number": "678-313-2815"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "328 CAMBRIAN DR",
"city": "KATHLEEN",
"state": "GA",
"postal_code": "310474516",
"telephone_number": "678-313-2815"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MUNGIN",
"first_name": "COREY",
"middle_name": "ALLEN",
"name_prefix": "Mr.",
"credential": "LCSW",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2019-05-10",
"last_updated": "2019-05-10",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "GA",
"license": "CSW006456",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Kathleen, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 10, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.