Ebony C Booker, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

CSW006762 Issued in GA

Practice address

135 Alicante St
College Park, GA 30349-8493

Phone

(404) 707-5743

NPI assigned

Sep 3, 2020

Last updated

Sep 3, 2020By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in GA, NY2 enrollments

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 2

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: ebonybooker@tdh.allscriptsdirect.net

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.

• The Southeast Permanente Medical Group

  • Internal Medicine Physician
  • Atlanta, GA
  • NPI 1245266956
  Medicare reassignment NPD
• Grow Healthcare Group PA

  • Mental Health Counselor
  • Miami, FL
  • NPI 1245845932

  Clinical, GA, NY

  Medicare reassignment NPD
• Sondermind Provider Network LLC

  • Clinical Social Worker
  • Denver, CO
  • NPI 1760854442

  GA

  Medicare reassignment NPD
• Valera Medical, P.C.

  • Psychiatry Physician
  • Brooklyn, NY
  • NPI 1437782349

  Clinical

  Medicare reassignment NPD
• Essential Wellness and Consulting

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Brooklyn, NY
  • NPI 1801622246
  NPD Authorized official
• Teladoc Health Medical Group, P.a.

  • Family Medicine Physician
  • Lewisville, TX
  • NPI 1245403567

  Clinical

  NPD

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

{
    "created_epoch": "1599091200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1599091200000",
    "number": "1689288045",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "135 ALICANTE ST",
            "city": "COLLEGE PARK",
            "state": "GA",
            "postal_code": "303498493",
            "telephone_number": "404-707-5743"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "135 ALICANTE ST",
            "city": "COLLEGE PARK",
            "state": "GA",
            "postal_code": "303498493",
            "telephone_number": "404-707-5743"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOOKER",
        "first_name": "EBONY",
        "middle_name": "C",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-09-03",
        "last_updated": "2020-09-03",
        "certification_date": "2020-09-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "GA",
            "license": "CSW006762",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "NONE",
            "affiliation": "N",
            "endpointDescription": "NONE",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "NONE",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "NONE",
            "address_1": "135 Alicante St",
            "city": "College Park",
            "state": "GA",
            "country_code": "US",
            "postal_code": "303498493",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Helena K Bentley, M.D.
• Scott Bertrand, D.C.
• Beyond Mental Wellness
• Michelle L Bigelow, LPN
• Bio-Medical Applications of Georgia, Inc. (Fresenius Medical Care Atlanta)
• Monica Denise Borum, LPN
• Mary Botchey, RN
• BR8K Thru Support Services (Br8k Thru Lyfe Inc.)
• Kira S Bradley, CACII
• William Brady, DO

• Clinical Social Worker in College Park, GA
• Providers in College Park, 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 Sep 3, 2020; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.