Individual provider Active NPI

Anne Hernandez

  • Clinical Social Worker
  • Atlanta, GA
National Provider Identifier
1639536485
Registry record updated Jan 25, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
CSW002260 Issued in GA
Practice address
80 Jesse Hill Jr Dr SE
Atlanta, GA 30303-3031
Phone
(404) 616-1782
NPI assigned
Jan 25, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 25, 2016

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 CSW002260 GA Primary

Addresses

Primary practice location

80 Jesse Hill Jr Dr SE
Atlanta, GA 30303-3031

Mailing address

143 Indian Hills PL NE
Marietta, GA 30068-3931
Phone (404) 895-0821

Other names 1

  • Anne Goforth Former name

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

LicenseStateTypeSpecialty
CSW002260GAMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1453680000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1453680000000",
    "number": "1639536485",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "143 INDIAN HILLS PL NE",
            "city": "MARIETTA",
            "state": "GA",
            "postal_code": "300683931",
            "telephone_number": "404-895-0821"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "80 JESSE HILL JR DR SE",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303033031",
            "telephone_number": "404-616-1782"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HERNANDEZ",
        "first_name": "ANNE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-01-25",
        "last_updated": "2016-01-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "GA",
            "license": "CSW002260",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ANNE",
            "last_name": "GOFORTH",
            "credential": "LCSW",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Atlanta, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 25, 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.