Individual provider Active NPI

Jocelyn Tang Chen Wise, LCSW

  • Clinical Social Worker
  • Atlanta, GA
National Provider Identifier
1629468178
Registry record updated Feb 4, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
CSW005125 Issued in GA
Practice address
12 Executive Park Dr NE
5TH Floor
Atlanta, GA 30329-2206
Phone
(404) 712-6943
Fax
(404) 712-7432
NPI assigned
Feb 4, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 4, 2015

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 CSW005125 GA Primary

Addresses

Primary practice location

12 Executive Park Dr NE
5TH Floor
Atlanta, GA 30329-2206

Mailing address

12 Executive Park Drive NE
5TH Floor
Atlanta, GA 30329
Phone (404) 712-6943

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
I20150526002037 GA Practitioner - Clinical Social Worker 2264752617 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Un of California, Irvine, College of Medicine, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
The Emory Clinic IncGroup PAC ID 8820901408, 3,507 clinicians

Practice addresses (Care Compare)

1123 Clairemont Ave
Decatur, GA 30030-1207
Phone (678) 928-7766

1365 Clifton Rd NE
Atlanta, GA 30322-1013
Phone (404) 778-7525

Merit-based Incentive Payment System (MIPS)

Final score
94.51 of 100Reported as apm
Quality
80.61
Promoting interoperability
100
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Sweet Olive Counseling Clinical CurrentSince Jan 18, 2024 Accepting new patients
The Emory Clinic Inc CurrentSince Feb 18, 2015 Accepting new patients

Locations

1365 Clifton Rd NE
Atlanta, GA 30322
Phone (404) 778-7525

101 W Ponce de Leon Ave
Ste 300
Decatur, GA 30030
Phone (404) 778-4889

1123 Clairemont Ave
Decatur, GA 30030
Phone (404) 905-5858

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1423008000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1423008000000",
    "number": "1629468178",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12 EXECUTIVE PARK DRIVE NE",
            "address_2": "5TH FLOOR",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "30329",
            "telephone_number": "404-712-6943",
            "fax_number": "404-712-7432"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12 EXECUTIVE PARK DR NE",
            "address_2": "5TH FLOOR",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303292206",
            "telephone_number": "404-712-6943",
            "fax_number": "404-712-7432"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WISE",
        "first_name": "JOCELYN",
        "middle_name": "TANG CHEN",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-02-04",
        "last_updated": "2015-02-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "GA",
            "license": "CSW005125",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Atlanta, GA

Sources for this page

Verify at the official NPI Registry.