Individual provider Active NPI

Kristen Anton, LCSW

  • Clinical Social Worker
  • Senoia, GA
National Provider Identifier
1881967420
Registry record updated Feb 21, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
CSW008641 Issued in GA
Practice address
80 Duck Pond Way
Senoia, GA 30276-3596
Phone
(334) 477-7527
NPI assigned
Feb 13, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 21, 2024

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 4303C AL
Clinical Social Worker 1041C0700X CSW008641 GA Primary

Addresses

Primary practice location

80 Duck Pond Way
Senoia, GA 30276-3596

Mailing address

80 Duck Pond Way
Senoia, GA 30276-3596

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
4303CALMDClinical Social Worker
CSW008641GAMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1329091200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1708473600000",
    "number": "1881967420",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "80 DUCK POND WAY",
            "city": "SENOIA",
            "state": "GA",
            "postal_code": "302763596"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "80 DUCK POND WAY",
            "city": "SENOIA",
            "state": "GA",
            "postal_code": "302763596",
            "telephone_number": "334-477-7527"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ANTON",
        "first_name": "KRISTEN",
        "name_prefix": "Mrs.",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-02-13",
        "last_updated": "2024-02-21",
        "certification_date": "2024-02-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "AL",
            "license": "4303C",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "GA",
            "license": "CSW008641",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Senoia, GA

Sources for this page

Verify at the official NPI Registry.