Individual provider Active NPI

Charlotte Nash, LCSW

  • Clinical Social Worker
  • Brunswick, GA
National Provider Identifier
1639610249
Registry record updated May 11, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
CSW006883 Issued in GA
Practice address
502 Gloucester St Ste 204
Brunswick, GA 31520-7092
Phone
(912) 580-9580
Fax
(912) 289-9389
NPI assigned
Mar 15, 2017
Last updated
May 11, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 11, 2023

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 CSW006883 GA Primary

Addresses

Primary practice location

502 Gloucester St Ste 204
Brunswick, GA 31520-7092

Mailing address

513 Gloucester St
Brunswick, GA 31520-7014
Phone (912) 580-9580

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
I20191029000766 GA Practitioner - Clinical Social Worker 3678807963 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Radiant Counseling, LLCGroup PAC ID 9133453426, 2 clinicians

Practice addresses (Care Compare)

513 Gloucester St
Brunswick, GA 31520-7014
Phone (912) 289-2497

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Radiant Counseling, LLC CurrentSince Mar 7, 2019 Accepting new patients

Locations

502 Gloucester St
Ste 204
Brunswick, GA 31520
Phone (912) 399-2441

513 Gloucester St
Brunswick, GA 31520
Phone (912) 289-2497

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1489536000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1683763200000",
    "number": "1639610249",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "513 GLOUCESTER ST",
            "city": "BRUNSWICK",
            "state": "GA",
            "postal_code": "315207014",
            "telephone_number": "912-580-9580",
            "fax_number": "912-289-9389"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "502 GLOUCESTER ST STE 204",
            "city": "BRUNSWICK",
            "state": "GA",
            "postal_code": "315207092",
            "telephone_number": "912-580-9580",
            "fax_number": "912-289-9389"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NASH",
        "first_name": "CHARLOTTE",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-03-15",
        "last_updated": "2023-05-11",
        "certification_date": "2023-05-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "GA",
            "license": "CSW006883",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brunswick, GA

Sources for this page

Verify at the official NPI Registry.