Active NPI
Jacqueline E Richards, CASE MANAGER
- Social Worker
- Atlanta, GA
National Provider Identifier
1861146607
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Social Worker
- Practice address
- 3084 Henderson Mill Rd
Atlanta, GA 30341-5638 - Phone
- (404) 212-1144
- NPI assigned
- Feb 10, 2022
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Social Worker | 104100000X | GA | Primary |
Addresses
Primary practice location
3084 Henderson Mill Rd
Atlanta, GA 30341-5638
Mailing address
3084 Henderson Mill Rd
Atlanta, GA 30341-5638
Phone (404) 212-1144
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 52-2372108 | Medicaid | GA | |
| 003217291A | Medicaid | GA |
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1644451200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1644451200000",
"number": "1861146607",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3084 HENDERSON MILL RD",
"city": "ATLANTA",
"state": "GA",
"postal_code": "303415638",
"telephone_number": "404-212-1144"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3084 HENDERSON MILL RD",
"city": "ATLANTA",
"state": "GA",
"postal_code": "303415638",
"telephone_number": "404-212-1144"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RICHARDS",
"first_name": "JACQUELINE",
"middle_name": "E",
"credential": "CASE MANAGER",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2022-02-10",
"last_updated": "2022-02-10",
"certification_date": "2022-02-10",
"status": "A"
},
"taxonomies": [
{
"code": "104100000X",
"taxonomy_group": "",
"desc": "Social Worker",
"state": "GA",
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "52-2372108",
"state": "GA"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "003217291A",
"state": "GA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Atlanta, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 10, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.