Individual provider Active NPI

Debra Legere, LCSW

  • Clinical Social Worker
  • Woodstock, GA
National Provider Identifier
1881012672
Registry record updated Dec 6, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
CSW-005907 Issued in GA
Practice address
242 Creekstone RDG
Woodstock, GA 30188-3732
Phone
(404) 918-2674
Fax
(678) 504-7775
NPI assigned
Mar 31, 2014
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 6, 2024

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 CSW-005907 GA Primary

Addresses

Primary practice location

242 Creekstone RDG
Woodstock, GA 30188-3732

Mailing address

3436 River Heights Xing SE
Marietta, GA 30067-4500
Phone (404) 918-2674

Other practice location 1

3823 Roswell Rd Ste 207
Marietta, GA 30062-6294
Phone (404) 918-2674

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
I20181102001461 GA Practitioner - Clinical Social Worker 5193078459 Practice locations: Marietta, GA; Woodstock, GA

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2009
Medicare assignment
May accept Medicare assignment
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

205 River Park N Dr
Woodstock, GA 30188-7835
Phone (404) 918-2674

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
CSW-005907GAMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Debra Legere Clinical CurrentSince Oct 29, 2023 Accepting new patients

Locations

242 Creekstone Rdg
Woodstock, GA 30188
Phone (678) 445-4184

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, 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": "1396224000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1733443200000",
    "number": "1881012672",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3436 RIVER HEIGHTS XING SE",
            "city": "MARIETTA",
            "state": "GA",
            "postal_code": "300674500",
            "telephone_number": "404-918-2674",
            "fax_number": "678-504-7775"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "242 CREEKSTONE RDG",
            "city": "WOODSTOCK",
            "state": "GA",
            "postal_code": "301883732",
            "telephone_number": "404-918-2674",
            "fax_number": "678-504-7775"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3823 Roswell Rd Ste 207",
            "address_purpose": "LOCATION",
            "city": "Marietta",
            "state": "GA",
            "postal_code": "300626294",
            "country_code": "US",
            "telephone_number": "404-918-2674",
            "fax_number": "770-995-1959",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LEGERE",
        "first_name": "DEBRA",
        "name_prefix": "Ms.",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-03-31",
        "last_updated": "2024-12-06",
        "certification_date": "2024-12-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "GA",
            "license": "CSW-005907",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Woodstock, GA

Sources for this page

Verify at the official NPI Registry.