Individual provider Active NPI

Akua Davis, LCSW

  • Clinical Social Worker
  • Atlanta, GA
National Provider Identifier
1679752976
Registry record updated Jan 8, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
CSW004636 Issued in GA
Practice address
100 Hartsfield Center Pkwy
Suite 500
Atlanta, GA 30354-1341
Phone
(404) 914-6354
NPI assigned
Nov 2, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 8, 2017

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X MSW003899 GA
Clinical Social Worker 1041C0700X CSW004636 GA Primary
School Social Worker 1041S0200X 654128 GA

Addresses

Primary practice location

100 Hartsfield Center Pkwy
Suite 500
Atlanta, GA 30354-1341

Mailing address

PO Box 361338
Decatur, GA 30036-1338

Other identifiers 1

IdentifierTypeStateIssuer
851572636AMedicaidGA

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
MSW003899GAMDProfessional Counselor
654128GAMDSchool Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1193961600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1483833600000",
    "number": "1679752976",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 361338",
            "city": "DECATUR",
            "state": "GA",
            "postal_code": "300361338"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 HARTSFIELD CENTER PKWY",
            "address_2": "SUITE 500",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303541341",
            "telephone_number": "404-914-6354"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAVIS",
        "first_name": "AKUA",
        "name_prefix": "Mrs.",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-11-02",
        "last_updated": "2017-01-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "GA",
            "license": "MSW003899",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "GA",
            "license": "CSW004636",
            "primary": true
        },
        {
            "code": "1041S0200X",
            "taxonomy_group": "",
            "desc": "Social Worker, School",
            "state": "GA",
            "license": "654128",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "851572636A",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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 8, 2017; 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.