Active NPI
Keyondra Lashay Delaney, LCSW
- Clinical Social Worker
- Loganville, GA
National Provider Identifier
1629669494
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- CSW008829
- Practice address
- 869 Sara Meadow Rd
Loganville, GA 30052-5949 - Phone
- (470) 774-9109
- NPI assigned
- Feb 3, 2021
- Sex
- Female
- 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 | CSW008829 | GA | Primary |
Addresses
Primary practice location
869 Sara Meadow Rd
Loganville, GA 30052-5949
Mailing address
869 Sara Meadow Rd
Loganville, GA 30052-5949
Phone (470) 774-9109
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 |
|---|---|---|---|
| CSW008829 | GA | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1612310400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1727827200000",
"number": "1629669494",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "869 SARA MEADOW RD",
"city": "LOGANVILLE",
"state": "GA",
"postal_code": "300525949",
"telephone_number": "470-774-9109"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "869 SARA MEADOW RD",
"city": "LOGANVILLE",
"state": "GA",
"postal_code": "300525949",
"telephone_number": "470-774-9109"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DELANEY",
"first_name": "KEYONDRA",
"middle_name": "LASHAY",
"credential": "LCSW",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2021-02-03",
"last_updated": "2024-10-02",
"certification_date": "2024-10-02",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "GA",
"license": "CSW008829",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Loganville, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 2, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.