Individual provider Active NPI

Brenda Maureen Romanchik, LCSW

  • Clinical Social Worker
  • Smyrna, GA
National Provider Identifier
1912119017
Registry record updated Aug 5, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
6801088037 Issued in MI
Practice address
3050 Atlanta Rd SE
Smyrna, GA 30080-8255
Phone
(248) 506-3137
NPI assigned
May 3, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 5, 2016

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 6801088037 MI Primary
Clinical Social Worker 1041C0700X CSW005336 GA

Addresses

Primary practice location

3050 Atlanta Rd SE
Smyrna, GA 30080-8255

Mailing address

3050 Atlanta Rd SE
Smyrna, GA 30080-8255
Phone (248) 506-3137

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
I20230502000133 GA Practitioner - Clinical Social Worker 7315120300 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

3499 S Cobb Dr SE
Smyrna, GA 30080-4170
Phone (248) 506-3137

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Great Oak Counseling Clinical CurrentSince Jan 18, 2023 Accepting new patients
Bright Path Counseling and Consulting LLC Current Accepting new patients
Catholic Charities of Southeast Michigan Clinical PastSince Oct 31, 2021 Accepting new patients

Locations

3499 S Cobb Dr SE
Smyrna, GA 30080
Phone (248) 506-3137

3050 Atlanta Rd SE
Smyrna, GA 30080
Phone (404) 272-4561

Organizations & group practices 3

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": "1178150400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1470355200000",
    "number": "1912119017",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3050 ATLANTA RD SE",
            "city": "SMYRNA",
            "state": "GA",
            "postal_code": "300808255",
            "telephone_number": "248-506-3137",
            "fax_number": "248-548-9239"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3050 ATLANTA RD SE",
            "city": "SMYRNA",
            "state": "GA",
            "postal_code": "300808255",
            "telephone_number": "248-506-3137"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROMANCHIK",
        "first_name": "BRENDA",
        "middle_name": "MAUREEN",
        "name_prefix": "Ms.",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-05-03",
        "last_updated": "2016-08-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MI",
            "license": "6801088037",
            "primary": true
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "GA",
            "license": "CSW005336",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Smyrna, GA

Sources for this page

Verify at the official NPI Registry.