Active NPI
Uplifted Living, LLC
- Clinical Social Worker
- Tucker, GA
National Provider Identifier
1619600178
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- Legal business name
- UPLIFTED LIVING, LLC
- Practice address
- 3654 S Marlborough Dr
Tucker, GA 30084-8313 - Phone
- (404) 376-1104
- NPI assigned
- Jul 2, 2022
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Rae K Sirott, LCSW
- Title
- Founder
- Phone
- (404) 376-1104
Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | Primary | ||
| Adult Mental Health Clinic/Center | 261QM0850X |
Addresses
Primary practice location
3654 S Marlborough Dr
Tucker, GA 30084-8313
Mailing address
3654 S Marlborough Dr
Tucker, GA 30084-8313
Phone (404) 376-1104
National Provider Directory
National Provider DirectoryPractitioners & affiliated clinicians
Practitioners 1
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1656720000000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1656720000000",
"number": "1619600178",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3654 S MARLBOROUGH DR",
"city": "TUCKER",
"state": "GA",
"postal_code": "300848313",
"telephone_number": "404-376-1104"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3654 S MARLBOROUGH DR",
"city": "TUCKER",
"state": "GA",
"postal_code": "300848313",
"telephone_number": "404-376-1104"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "UPLIFTED LIVING, LLC",
"organizational_subpart": "NO",
"enumeration_date": "2022-07-02",
"last_updated": "2022-07-02",
"certification_date": "2022-07-02",
"status": "A",
"authorized_official_last_name": "SIROTT",
"authorized_official_first_name": "RAE",
"authorized_official_middle_name": "K",
"authorized_official_title_or_position": "FOUNDER",
"authorized_official_telephone_number": "404-376-1104",
"authorized_official_credential": "LCSW"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Social Worker, Clinical",
"state": null,
"license": null,
"primary": true
},
{
"code": "261QM0850X",
"taxonomy_group": "",
"desc": "Clinic/Center, Adult Mental Health",
"state": null,
"license": null,
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Tucker, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 2, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.