Individual provider Active NPI

Stephanie Hemenway Spelsberg, LCSW

  • Clinical Social Worker
  • Canton, GA
National Provider Identifier
1841217544
Registry record updated Sep 27, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
CSW003722 Issued in GA
Practice address
191 Lamar Haley Pkwy
Canton, GA 30114-2699
Phone
(770) 704-1600
Fax
(770) 704-1610
NPI assigned
Jul 17, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 27, 2011

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 SW8328 FL
Clinical Social Worker 1041C0700X CSW003722 GA Primary

Addresses

Primary practice location

191 Lamar Haley Pkwy
Canton, GA 30114-2699

Mailing address

1401 Applewood Dr
Ste 1
Dalton, GA 30720-2699
Phone (706) 270-5003

Other identifiers 1

IdentifierTypeStateIssuer
767799500MedicaidFL

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
I20111020000644 GA Practitioner - Clinical Social Worker 3678579745 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Highland Rivers Community Service BoardGroup PAC ID 9032000245, 57 clinicians

Practice addresses (Care Compare)

191 Lamar Haley Pkwy
Canton, GA 30114-8019
Phone (770) 720-3510

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
CSW003722GAMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Highland Rivers CSB CurrentSince Sep 12, 2011 Accepting new patients
Highland Rivers Community Service Board Current Accepting new patients
Highland Rivers CSB CurrentSince Sep 12, 2011 Accepting new patients
Lifestream Behavioral Center Inc Past Accepting new patients

Locations

100 Wright Ct NE
Calhoun, GA 30701
Phone (706) 629-5200

191 Lamar Haley Pkwy
Canton, GA 30114
Phone (770) 704-1600

650 Joe Frank Harris Pkwy SE
Cartersville, GA 30120
Phone (770) 387-3538

1401 Applewood Dr
Ste 1
Dalton, GA 30720
Phone (706) 270-5003

1503 N Tibbs Rd
Dalton, GA 30720
Phone (706) 229-4507

900 Shugart Rd
Ste B
Dalton, GA 30720
Phone (706) 270-5027

1179 Progress Rd
Ellijay, GA 30540
Phone (706) 635-2739

323 Roland Rd
Jasper, GA 30143
Phone (706) 253-1112

Organizations & group practices 4

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": "1153094400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1317081600000",
    "number": "1841217544",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1401 APPLEWOOD DR",
            "address_2": "STE 1",
            "city": "DALTON",
            "state": "GA",
            "postal_code": "307202699",
            "telephone_number": "706-270-5003",
            "fax_number": "706-270-5111"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "191 LAMAR HALEY PKWY",
            "city": "CANTON",
            "state": "GA",
            "postal_code": "301142699",
            "telephone_number": "770-704-1600",
            "fax_number": "770-704-1610"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SPELSBERG",
        "first_name": "STEPHANIE",
        "middle_name": "HEMENWAY",
        "name_prefix": "Mrs.",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-17",
        "last_updated": "2011-09-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "FL",
            "license": "SW8328",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "GA",
            "license": "CSW003722",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "767799500",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Canton, GA

Sources for this page

Verify at the official NPI Registry.