The Peaceful Place, LLC

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

CSW004964 Issued in GA

Legal business name

THE PEACEFUL PLACE, LLC

Practice address

1799 Clairmont Rd
Decatur, GA 30033-4005

Phone

(404) 490-0664

NPI assigned

Apr 27, 2016

Last updated

Apr 27, 2016By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Patrick Bryant, LCSWNPI 1285067686

Title

Director

Phone

(404) 490-0664

Specialties & licenses 1

Addresses

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Patrick Bryant, LCSW

  • Clinical Social Worker
  • Decatur, GA
  • NPI 1285067686
  Authorized official Same address or phone

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

{
    "created_epoch": "1461715200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1461715200000",
    "number": "1609221605",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1799 CLAIRMONT RD",
            "city": "DECATUR",
            "state": "GA",
            "postal_code": "300334005",
            "telephone_number": "404-490-0664"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1799 CLAIRMONT RD",
            "city": "DECATUR",
            "state": "GA",
            "postal_code": "300334005",
            "telephone_number": "404-490-0664"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THE PEACEFUL PLACE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-04-27",
        "last_updated": "2016-04-27",
        "status": "A",
        "authorized_official_last_name": "BRYANT",
        "authorized_official_first_name": "PATRICK",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "404-490-0664",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Social Worker, Clinical",
            "state": "GA",
            "license": "CSW004964",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Clinical Social Worker in Decatur, GA
• Providers in Decatur, GA by specialty
• Clinical Social Worker in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 27, 2016; 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.