Individual provider Active NPI

Rose Marie Williams, LCSW

  • Clinical Social Worker
  • Conyers, GA
National Provider Identifier
1902283542
Registry record updated May 4, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
CSW005212 Issued in GA
Practice address
1623 Cherry Hill CT SW
Conyers, GA 30094-6273
Phone
(770) 568-9089
NPI assigned
May 4, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 4, 2015

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 CSW005212 GA Primary

Addresses

Primary practice location

1623 Cherry Hill CT SW
Conyers, GA 30094-6273

Mailing address

1623 Cherry Hill CT SW
Conyers, GA 30094-6273
Phone (770) 568-9089

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
I20170925001954 GA Practitioner - Clinical Social Worker 0840564167 Reassigns benefits to 1 organization
Practice locations: Conyers, GA

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1996
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1226 Royal Dr SW
Suite E
Conyers, GA 30094-5926
Phone (678) 310-9069

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
CSW005212GAMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Restoring Wellness Counseling Clinical CurrentSince Jan 1, 2021 Accepting new patients
Restoring Wellness Counseling LLC Clinical CurrentSince Jan 1, 2021 Accepting new patients

Locations

1226 Royal Dr SW
Ste E
Conyers, GA 30094
Phone (678) 310-9069

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1430697600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1430697600000",
    "number": "1902283542",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1623 CHERRY HILL CT SW",
            "city": "CONYERS",
            "state": "GA",
            "postal_code": "300946273",
            "telephone_number": "770-568-9089"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1623 CHERRY HILL CT SW",
            "city": "CONYERS",
            "state": "GA",
            "postal_code": "300946273",
            "telephone_number": "770-568-9089"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILLIAMS",
        "first_name": "ROSE",
        "middle_name": "MARIE",
        "name_prefix": "Ms.",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-05-04",
        "last_updated": "2015-05-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "GA",
            "license": "CSW005212",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Conyers, GA

Sources for this page

Verify at the official NPI Registry.