NPIMap

Individual provider Active NPI

Kenyada Antoinette Duncan, LCSW

  • Clinical Social Worker
  • Decatur, GA
National Provider Identifier
1760670822
Registry record updated Oct 12, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
CSW003461 Issued in GA
Practice address
4319 Covington Hwy
Suite 214
Decatur, GA 30035-1210
Phone
(404) 284-1191
NPI assigned
Oct 12, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 12, 2007

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 CSW003461 GA Primary

Addresses

Primary practice location

4319 Covington Hwy
Suite 214
Decatur, GA 30035-1210

Mailing address

4319 Covington Hwy
Suite 214
Decatur, GA 30035-1210
Phone (404) 284-1191

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
CSW003461GAMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Care Counseling & Psychological Services, LLC Past Accepting new patients
Trinity Counseling & Consulting, Inc. Past Accepting new patients

Organizations & group practices 2

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": "1192147200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1192147200000",
    "number": "1760670822",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4319 COVINGTON HWY",
            "address_2": "SUITE 214",
            "city": "DECATUR",
            "state": "GA",
            "postal_code": "300351210",
            "telephone_number": "404-284-1191"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4319 COVINGTON HWY",
            "address_2": "SUITE 214",
            "city": "DECATUR",
            "state": "GA",
            "postal_code": "300351210",
            "telephone_number": "404-284-1191"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DUNCAN",
        "first_name": "KENYADA",
        "middle_name": "ANTOINETTE",
        "name_prefix": "Mrs.",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-10-12",
        "last_updated": "2007-10-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "GA",
            "license": "CSW003461",
            "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 Oct 12, 2007; 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.