Sean Michael Reilly, L.C.S.W.

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

CSW006739 Issued in GA

Practice address

1815 Old 41 Hwy NW
Suite 110
Kennesaw, GA 30152

Phone

(678) 468-9103

NPI assigned

Sep 9, 2015

Last updated

Aug 5, 2019By the provider in NPPES

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1441756800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1564963200000",
    "number": "1912375817",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1815 OLD 41 HWY NW",
            "address_2": "SUITE 110",
            "city": "KENNESAW",
            "state": "GA",
            "postal_code": "30152",
            "telephone_number": "678-468-9103"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1815 OLD 41 HWY NW",
            "address_2": "SUITE 110",
            "city": "KENNESAW",
            "state": "GA",
            "postal_code": "30152",
            "telephone_number": "678-468-9103"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REILLY",
        "first_name": "SEAN",
        "middle_name": "MICHAEL",
        "name_prefix": "Mr.",
        "credential": "L.C.S.W.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-09-09",
        "last_updated": "2019-08-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "TN",
            "license": "LSW0000006235",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "FL",
            "license": "SW11749",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "GA",
            "license": "CSW006739",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Regency Hospice of Georgia, LLC (Regency Hospice of Northeast Georgia)
• Amy Leigh Reich, D.C.
• Bruce Edwin Reid, O.D.
• Kimberly Reid, RN
• Pamela Jaycille Reid
• Courtney Nicole Reina, FNP
• Amarae Reinard
• Tameka Shonte Rembert, RN
• Melody Elizabeth Reseter
• Reside Well, LLC (Assisting Hands Kennesaw)

• Clinical Social Worker in Kennesaw, GA
• Providers in Kennesaw, GA by specialty
• Clinical Social Worker in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 5, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.