Individual provider Active NPI

Yvanna Pantner, LMSW

  • Clinical Social Worker
  • Decatur, GA
National Provider Identifier
1669199451
Registry record updated Nov 5, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
MSW011530 Issued in GA
Practice address
119 E Court SQ Ste 210
Decatur, GA 30030-2522
Phone
(404) 492-6121
NPI assigned
Oct 24, 2022
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 5, 2024

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 MSW011530 GA Primary

Addresses

Primary practice location

119 E Court SQ Ste 210
Decatur, GA 30030-2522

Mailing address

119 E Court SQ Ste 210
Decatur, GA 30030-2522
Phone (434) 382-9417

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
MSW011530GAMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Lindsy Wagner LLC Clinical PastSince Sep 16, 2024 Accepting new patients

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1666569600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1730764800000",
    "number": "1669199451",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "119 E COURT SQ STE 210",
            "city": "DECATUR",
            "state": "GA",
            "postal_code": "300302522",
            "telephone_number": "434-382-9417"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "119 E COURT SQ STE 210",
            "city": "DECATUR",
            "state": "GA",
            "postal_code": "300302522",
            "telephone_number": "404-492-6121"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PANTNER",
        "first_name": "YVANNA",
        "credential": "LMSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-10-24",
        "last_updated": "2024-11-05",
        "certification_date": "2024-11-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "GA",
            "license": "MSW011530",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Decatur, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 5, 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.

Verify at the official NPI Registry.