Active NPI
Tatiana Otalora
- Social Worker
- Norcross, GA
National Provider Identifier
1922406214
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Social Worker
- License
- MSW006471
- Practice address
- 6020 Dawson Blvd
Norcross, GA 30093-1229 - Phone
- (770) 662-0249
- NPI assigned
- Dec 18, 2014
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Social Worker | 104100000X | MSW006471 | GA | Primary |
| Social Worker | 104100000X | 089613-1 | NY |
Addresses
Primary practice location
6020 Dawson Blvd
Norcross, GA 30093-1229
Mailing address
576 Killian Hill Rd SW
Lilburn, GA 30047-4064
Phone (678) 914-3315
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| MSW006471 | GA | MD | Social Worker |
| 089613-1 | NY | MD | Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1418860800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1418860800000",
"number": "1922406214",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "576 KILLIAN HILL RD SW",
"city": "LILBURN",
"state": "GA",
"postal_code": "300474064",
"telephone_number": "678-914-3315"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6020 DAWSON BLVD",
"city": "NORCROSS",
"state": "GA",
"postal_code": "300931229",
"telephone_number": "770-662-0249"
}
],
"practiceLocations": [],
"basic": {
"last_name": "OTALORA",
"first_name": "TATIANA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2014-12-18",
"last_updated": "2014-12-18",
"status": "A"
},
"taxonomies": [
{
"code": "104100000X",
"taxonomy_group": "",
"desc": "Social Worker",
"state": "GA",
"license": "MSW006471",
"primary": true
},
{
"code": "104100000X",
"taxonomy_group": "",
"desc": "Social Worker",
"state": "NY",
"license": "089613-1",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Norcross, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 18, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.