Active NPI
Mark Stoholski, LCSW
- Clinical Social Worker
- Brookhaven, GA
National Provider Identifier
1649819970
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- CSW008571
- Practice address
- 2801 Buford Hwy NE Ste T10
Brookhaven, GA 30329-2142 - Phone
- (470) 851-6343
- NPI assigned
- Jan 3, 2020
- Sex
- Male
- Sole proprietor
- Yes
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 | CSW008571 | GA | Primary |
Addresses
Primary practice location
2801 Buford Hwy NE Ste T10
Brookhaven, GA 30329-2142
Mailing address
2801 Buford Hwy NE Ste T10
Brookhaven, GA 30329-2142
Phone (470) 851-6343
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
- Opted out of Medicare
- Yes, effective Jan 1, 2025 through Jan 1, 2027
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| CSW008571 | GA | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1578009600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1687824000000",
"number": "1649819970",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2801 BUFORD HWY NE STE T10",
"city": "BROOKHAVEN",
"state": "GA",
"postal_code": "303292142",
"telephone_number": "470-851-6343"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2801 BUFORD HWY NE STE T10",
"city": "BROOKHAVEN",
"state": "GA",
"postal_code": "303292142",
"telephone_number": "470-851-6343"
}
],
"practiceLocations": [],
"basic": {
"last_name": "STOHOLSKI",
"first_name": "MARK",
"credential": "LCSW",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2020-01-03",
"last_updated": "2023-06-27",
"certification_date": "2023-06-27",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "GA",
"license": "CSW008571",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Brookhaven, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 27, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.