Individual provider Active NPI

Christina K Carrick, LCSW

  • Clinical Social Worker
  • Decatur, GA
National Provider Identifier
1720258080
Registry record updated Mar 6, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
CSW006534 Issued in GA
Practice address
235 E Ponce de Leon Ave Ste 120
Decatur, GA 30030-3412
Phone
(404) 242-3395
NPI assigned
Mar 3, 2008
Last updated
Mar 6, 2024By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 6, 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 CSW006534 GA Primary

Addresses

Primary practice location

235 E Ponce de Leon Ave Ste 120
Decatur, GA 30030-3412

Mailing address

1604 Briarcliff Rd NE Apt 6
Atlanta, GA 30306-2130
Phone (404) 242-3395

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
CSW006534GAMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Carrick Counseling and Consulting, LLC Clinical CurrentSince May 24, 2020 Accepting new patients

Locations

108 E Ponce de Leon Ave
Ste 204
Decatur, GA 30030
Phone (404) 382-8788

235 E Ponce de Leon Ave
Ste 120
Decatur, GA 30030
Phone (404) 242-3395

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1204502400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1709683200000",
    "number": "1720258080",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1604 BRIARCLIFF RD NE APT 6",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303062130",
            "telephone_number": "404-242-3395"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "235 E PONCE DE LEON AVE STE 120",
            "city": "DECATUR",
            "state": "GA",
            "postal_code": "300303412",
            "telephone_number": "404-242-3395"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CARRICK",
        "first_name": "CHRISTINA",
        "middle_name": "K",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-03-03",
        "last_updated": "2024-03-06",
        "certification_date": "2024-03-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "GA",
            "license": "CSW006534",
            "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 Mar 6, 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.