Individual provider Active NPI

Elizabeth Toledo, LCSW

  • Clinical Social Worker
  • Norcross, GA
National Provider Identifier
1851564926
Registry record updated Feb 1, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
CSW004248 Issued in GA
Practice address
716 Holcomb Bridge Rd
FL 2
Norcross, GA 30071-1325
Phone
(404) 363-7890
Fax
(404) 363-3923
NPI assigned
Apr 9, 2008
Last updated
Feb 1, 2017By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 1, 2017

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X NU
Mental Health Counselor 101YM0800X NU
Clinical Social Worker 1041C0700X CSW004248 GA Primary

Addresses

Primary practice location

716 Holcomb Bridge Rd
FL 2
Norcross, GA 30071-1325

Mailing address

3765 Teton Pass
Ellenwood, GA 30294-6653
Phone (404) 312-6531

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
I20101108000454 GA Practitioner - Clinical Social Worker 4587859368 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

124 S Main St
1H
Jonesboro, GA 30236-3696
Phone (404) 312-6531

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
CSW004248GAMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Teladoc Health Medical Group, P.a. Mental Health Current Accepting new patients
Angels Recovery Mental Health CurrentSince May 5, 2014 Accepting new patients

Locations

6755 Peachtree Industrial Blvd
Ste 110
Atlanta, GA 30360
Phone (404) 312-6531

124 S Main St
Ste 1H
Jonesboro, GA 30236
Phone (404) 312-6531

716 Holcomb Bridge Rd
Fl 2
Norcross, GA 30071
Phone (404) 363-7890

Interoperability endpoints

  • Direct secure messaging: elizabethtoledo@tdh.allscriptsdirect.net

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1207699200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1485907200000",
    "number": "1851564926",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3765 TETON PASS",
            "city": "ELLENWOOD",
            "state": "GA",
            "postal_code": "302946653",
            "telephone_number": "404-312-6531",
            "fax_number": "423-822-5729"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "716 HOLCOMB BRIDGE RD",
            "address_2": "FL 2",
            "city": "NORCROSS",
            "state": "GA",
            "postal_code": "300711325",
            "telephone_number": "404-363-7890",
            "fax_number": "404-363-3923"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TOLEDO",
        "first_name": "ELIZABETH",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-04-09",
        "last_updated": "2017-02-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "GA",
            "license": "CSW004248",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Norcross, GA

Sources for this page

Verify at the official NPI Registry.