Cynthia Bacon-Whitted, LCSW

Primary specialty

Social WorkerTaxonomy code 104100000X

License

MSW002077 Issued in GA

Practice address

6200 Riveroak Ter
College Park, GA 30349-4095

Phone

(404) 483-0577

NPI assigned

Dec 18, 2006

Last updated

Jan 19, 2017By 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 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

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

• Willow Oak Foundation, Inc.

  • Community/Behavioral Health Agency
  • Newnan, GA
  • NPI 1588273528
  NPD (past)

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

{
    "created_epoch": "1166400000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1484784000000",
    "number": "1730242009",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 162391",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303212391",
            "telephone_number": "404-483-0577"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6200 RIVEROAK TER",
            "city": "COLLEGE PARK",
            "state": "GA",
            "postal_code": "303494095",
            "telephone_number": "404-483-0577"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BACON-WHITTED",
        "first_name": "CYNTHIA",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-12-18",
        "last_updated": "2017-01-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "GA",
            "license": "MSW002077",
            "primary": true
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "GA",
            "license": "CSW005945",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000849032A",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Ashford Dental Inc.
• Atlanta Trauma Therapy & Consulting
• Atlanta Vamc
• Atlanta's Hair Replacement and Weaving Salon Inc (Atlanta's Hair Salon LLC)
• Teri Ayewoh, LMSW, CAMS-11
• Bagley Youth Development
• Travis Barber, CLC
• Lisa Michelle Bartell, BACHELOR
• Cerissa Bartlett, LPC
• Michael Clifford Basille, D.C.

• Social Worker in College Park, GA
• Providers in College Park, GA by specialty
• Social Worker in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 19, 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.