Individual provider Active NPI

Deborah Elaine Sills, PH.D, LCSW

  • Clinical Social Worker
  • Decatur, GA
National Provider Identifier
1770628497
Registry record updated Jul 9, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
2305 Issued in GA
Practice address
2828 Wesley Chapel Rd
Decatur, GA 30034-2313
Phone
(770) 413-8932
Fax
(770) 484-2483
NPI assigned
Feb 20, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 9, 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 2305 GA Primary

Addresses

Primary practice location

2828 Wesley Chapel Rd
Decatur, GA 30034-2313

Mailing address

6754 Grey Rock Way
Lithonia, GA 30058-3077
Phone (770) 413-8932

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)
Enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
2305GAMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Exceptionally Yours Autism and Educational Services LLC Clinical Current Accepting new patients
Level Up Community Service Program LLC Clinical Current Accepting new patients
Atlanta Metro Psychiatric Associates Past Accepting new patients
Fulton County Mhddad Past Accepting new patients
Fulton County Mental Health Center Past Accepting new patients

Organizations & group practices 5

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": "1171929600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183939200000",
    "number": "1770628497",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6754 GREY ROCK WAY",
            "city": "LITHONIA",
            "state": "GA",
            "postal_code": "300583077",
            "telephone_number": "770-413-8932",
            "fax_number": "770-484-2483"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2828 WESLEY CHAPEL RD",
            "city": "DECATUR",
            "state": "GA",
            "postal_code": "300342313",
            "telephone_number": "770-413-8932",
            "fax_number": "770-484-2483"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SILLS",
        "first_name": "DEBORAH",
        "middle_name": "ELAINE",
        "credential": "PH.D, LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-02-20",
        "last_updated": "2007-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "GA",
            "license": "2305",
            "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 Jul 9, 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.