Individual provider Active NPI

Tamekis Williams, MSW, LCSW

  • Clinical Social Worker
  • Douglasville, GA
National Provider Identifier
1801278023
Registry record updated Sep 25, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
CSW005654 Issued in GA
Practice address
8322 Office Park Dr
Ste H
Douglasville, GA 30134-6936
Phone
(770) 927-7272
Fax
(770) 741-2233
NPI assigned
Jun 24, 2015
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 25, 2016

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 CSW005654 GA Primary

Addresses

Primary practice location

8322 Office Park Dr
Ste H
Douglasville, GA 30134-6936

Mailing address

PO Box 641
Douglasville, GA 30133-0641

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
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 1

Enrollment IDStateProvider typePAC IDDetails
I20170802002572 GA Practitioner - Clinical Social Worker 5395016844 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2009
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

8306 Office Park Dr
Suite a
Douglasville, GA 30134-6935

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
CSW005654GAMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Real Life Solutions Ga CurrentSince Jun 2, 2017 Accepting new patients

Locations

8306 Office Park Dr
Ste A
Douglasville, GA 30134
Phone (770) 927-7272

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": "1435104000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1474761600000",
    "number": "1801278023",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 641",
            "city": "DOUGLASVILLE",
            "state": "GA",
            "postal_code": "301330641"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8322 OFFICE PARK DR",
            "address_2": "STE H",
            "city": "DOUGLASVILLE",
            "state": "GA",
            "postal_code": "301346936",
            "telephone_number": "770-927-7272",
            "fax_number": "770-741-2233"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILLIAMS",
        "first_name": "TAMEKIS",
        "credential": "MSW, LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-06-24",
        "last_updated": "2016-09-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "GA",
            "license": "CSW005654",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Douglasville, GA

Sources for this page

Verify at the official NPI Registry.