Individual provider Active NPI

Marie De Noel Pham, LMSW

  • Clinical Social Worker
  • Atlanta, GA
National Provider Identifier
1760056600
Registry record updated May 15, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
MSW009277 Issued in GA
Practice address
520 Park Dr NE Unit 524
Atlanta, GA 30306-5111
Phone
(404) 229-8655
NPI assigned
May 15, 2021
Last updated
May 15, 2021By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 15, 2021

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 MSW009277 GA Primary

Addresses

Primary practice location

520 Park Dr NE Unit 524
Atlanta, GA 30306-5111

Mailing address

520 Park Dr NE Unit 524
Atlanta, GA 30306-5111
Phone (404) 229-8655

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
MSW009277GAMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1621036800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1621036800000",
    "number": "1760056600",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "520 PARK DR NE UNIT 524",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303065111",
            "telephone_number": "404-229-8655"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "520 PARK DR NE UNIT 524",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303065111",
            "telephone_number": "404-229-8655"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PHAM",
        "first_name": "MARIE",
        "middle_name": "DE NOEL",
        "name_prefix": "Ms.",
        "credential": "LMSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-05-15",
        "last_updated": "2021-05-15",
        "certification_date": "2021-05-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "GA",
            "license": "MSW009277",
            "primary": true
        }
    ],
    "identifiers": [],
    "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 May 15, 2021; 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.