Serita Conaway – Social Worker in Columbus, GA

Key facts

NPI: 1861920605
Entity type: Individual (NPI type 1)
Primary specialty: Social Worker 104100000X
Practice address: 1727 Boxwood PL
Columbus, GA 31906-2328
Phone: (706) 596-5983
NPI assigned: May 24, 2017
Sex: Female
Sole proprietor: No

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.

Project Change Clubhouse Clinical Social Worker · Columbus, GA · NPI 1821328923

NPD (past)

Medicare participation

Medicare fee-for-service enrollment: Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD): No

Practice roles

Organization	Specialty	Status	New patients
Project Change Clubhouse		Past	Accepting new patients

Specialties & licenses

Specialty (taxonomy)	Code	License	State	Primary
Social Worker	104100000X			Yes

Addresses

Primary practice location

1727 Boxwood PL
Columbus, GA 31906-2328

Mailing address

2100 Comer Ave
Columbus, GA 31904-8725

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on May 24, 2017.

{
    "created_epoch": "1495584000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1495584000000",
    "number": "1861920605",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2100 COMER AVE",
            "city": "COLUMBUS",
            "state": "GA",
            "postal_code": "319048725"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1727 BOXWOOD PL",
            "city": "COLUMBUS",
            "state": "GA",
            "postal_code": "319062328",
            "telephone_number": "706-596-5983"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CONAWAY",
        "first_name": "SERITA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-05-24",
        "last_updated": "2017-05-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Columbus, GA

All providers in Columbus, GA · Social Worker in Georgia

Sources for this page

NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on May 24, 2017. Information in NPPES is self-reported and not verified by CMS.
NUCC Health Care Provider Taxonomy: specialty names.
National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.