Alan B Kirk, PHD, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

CSW003435 Issued in GA

Practice address

1605 Roberta Dr SW
Marietta, GA 30008-3855

Phone

(770) 419-3120

Fax

(770) 419-3121

NPI assigned

Aug 11, 2011

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Philosophy

State licenses

Practice roles

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.

• Good Samaritan Health Center of Cobb

  • Federally Qualified Health Center (FQHC)
  • Marietta, GA
  • NPI 1881923126
  NPD (past)
• Summit Medical Group, Inc

  • Family Medicine Physician
  • Erlanger, KY
  • NPI 1750343216
  NPD (past)

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

{
    "created_epoch": "1313020800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1313020800000",
    "number": "1659650331",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1605 ROBERTA DR SW",
            "city": "MARIETTA",
            "state": "GA",
            "postal_code": "300083855",
            "telephone_number": "770-419-3120",
            "fax_number": "770-419-3121"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1605 ROBERTA DR SW",
            "city": "MARIETTA",
            "state": "GA",
            "postal_code": "300083855",
            "telephone_number": "770-419-3120",
            "fax_number": "770-419-3121"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIRK",
        "first_name": "ALAN",
        "middle_name": "B",
        "credential": "PHD, LCSW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-08-11",
        "last_updated": "2011-08-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "GA",
            "license": "CSW003435",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LCSW LICENSE #",
            "identifier": "CSW003435",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Joseph K Kinuthia, MD
• Ann Kiplagat, RBT
• Thomas Joseph Kirchhofer, DC
• Pamela J Kirchner, PT
• Kirk a. Kimmerling, D.D.S., P.C.
• Adee Lee Kirkconnell, RBT
• Dean M. Kirkel, MD
• Marjan Zarif Kirkland, FNP-C
• Elizabeth R Kirkley, C.N.M.
• Teri Danielle Kirkpatrick, PT

• Clinical Social Worker in Marietta, GA
• Providers in Marietta, GA by specialty
• Clinical Social Worker in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 11, 2011; 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.