Individual provider Active NPI

Lisa M Talley

  • Clinical Social Worker
  • Atlanta, GA
National Provider Identifier
1740785831
Registry record updated Apr 27, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
CSW008437 Issued in GA
Practice address
1405 Woodland Ave SE
Atlanta, GA 30316-3172
Phone
(404) 468-3881
NPI assigned
Mar 29, 2018
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 27, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 6801103514 MI
Clinical Social Worker 1041C0700X CSW008437 GA Primary

Addresses

Primary practice location

1405 Woodland Ave SE
Atlanta, GA 30316-3172

Mailing address

1405 Woodland Ave SE
Atlanta, GA 30316-3172
Phone (404) 468-3881

Other practice location 1

29330 Bermuda Ln
Southfield, MI 48076-1606
Phone (404) 468-3881

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI, GA2 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

Enrollment IDStateProvider typePAC IDDetails
I20200204000678 MI Practitioner - Clinical Social Worker 8820424252 Reassigns benefits to 1 organization
I20230629002620 GA Practitioner - Clinical Social Worker 8820424252 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
CSW008437GAMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Grow Healthcare Group PA Clinical CurrentSince May 30, 2023 Accepting new patients

Locations

66 W Flagler St
Ste 900
Miami, FL 33130
Phone (786) 244-7711

715 Peachtree St NE
Ste 100
Atlanta, GA 30308
Phone (202) 972-4964

250 Monroe Ave NW
Ste 400
Grand Rapids, MI 49503
Phone (616) 441-4616

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": "1522281600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1745712000000",
    "number": "1740785831",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1405 WOODLAND AVE SE",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303163172",
            "telephone_number": "404-468-3881"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1405 WOODLAND AVE SE",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303163172",
            "telephone_number": "404-468-3881"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "29330 Bermuda Ln",
            "address_purpose": "LOCATION",
            "city": "Southfield",
            "state": "MI",
            "postal_code": "480761606",
            "country_code": "US",
            "telephone_number": "404-468-3881",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "TALLEY",
        "first_name": "LISA",
        "middle_name": "M",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-03-29",
        "last_updated": "2025-04-27",
        "certification_date": "2025-04-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MI",
            "license": "6801103514",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "GA",
            "license": "CSW008437",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Atlanta, GA

Sources for this page

Verify at the official NPI Registry.