Individual provider Active NPI

Caroline Elizabeth Lozen Bufalini, LCSW

  • Clinical Social Worker
  • Duluth, GA
National Provider Identifier
1912623026
Registry record updated Oct 19, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
CSW007266 Issued in GA
Practice address
3735 Longlake Dr
Duluth, GA 30097-2295
Phone
(678) 301-9827
NPI assigned
Oct 19, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 19, 2022

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 CSW007266 GA Primary

Addresses

Primary practice location

3735 Longlake Dr
Duluth, GA 30097-2295

Mailing address

3735 Longlake Dr
Duluth, GA 30097-2295
Phone (678) 301-9827

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
I20230330002986 GA Practitioner - Clinical Social Worker 8820463037 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Sondermind Provider Network LLCGroup PAC ID 9537572490, 1,295 clinicians

Practice addresses (Care Compare)

3372 Peachtree Rd NE
Suite 115
Atlanta, GA 30326-1963
Phone (866) 630-0966

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
CSW007266GAMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Sondermind Provider Network LLC Clinical CurrentSince Feb 21, 2023 Accepting new patients

Locations

3348 Peachtree Rd NE
Ste 700
Atlanta, GA 30326
Phone (720) 712-7900

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1666137600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1666137600000",
    "number": "1912623026",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3735 LONGLAKE DR",
            "city": "DULUTH",
            "state": "GA",
            "postal_code": "300972295",
            "telephone_number": "678-301-9827"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3735 LONGLAKE DR",
            "city": "DULUTH",
            "state": "GA",
            "postal_code": "300972295",
            "telephone_number": "678-301-9827"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BUFALINI",
        "first_name": "CAROLINE",
        "middle_name": "ELIZABETH LOZEN",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-10-19",
        "last_updated": "2022-10-19",
        "certification_date": "2022-10-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "GA",
            "license": "CSW007266",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Duluth, GA

Sources for this page

Verify at the official NPI Registry.