Tyshawn Kingsberry, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

CSW006341 Issued in GA

Practice address

160 Camerons Way
Covington, GA 30016-1162

Phone

(404) 348-3948

NPI assigned

Oct 10, 2006

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in GA, LA2 enrollments

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 2

Specialty

Clinical Social Worker

Education

Other, 1998

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Lifesource of North CarolinaGroup PAC ID 7416132428, 172 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

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.

• Lifesource of North Carolina

  • General Practice Physician
  • Rome, GA
  • NPI 1962940817

  Clinical

  Medicare reassignment Care Compare group NPD
• Sondermind Provider Network LLC

  • Clinical Social Worker
  • Denver, CO
  • NPI 1760854442

  GA

  Medicare reassignment NPD
• Royal Court of Esther Inc

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Conyers, GA
  • NPI 1417456898
  NPD Authorized official
• Lifesource of North Carolina

  • Psychologist
  • Milton, FL
  • NPI 1730648288

  Clinical

  NPD

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

{
    "created_epoch": "1160438400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1517356800000",
    "number": "1932297652",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "160 CAMERONS WAY",
            "city": "COVINGTON",
            "state": "GA",
            "postal_code": "300161162"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "160 CAMERONS WAY",
            "city": "COVINGTON",
            "state": "GA",
            "postal_code": "300161162",
            "telephone_number": "404-348-3948"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KINGSBERRY",
        "first_name": "TYSHAWN",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-10-10",
        "last_updated": "2018-01-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "GA",
            "license": "CSW006341",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Nazir Ahmad Khawaja, M.D.
• Andrew Kilday, MD
• Kimpam, Inc. Dba. the Medicine Shoppe
• Kindly Companions LLC
• Shelby Boggus King, PA-C
• Musau Kithome
• Knack Medical Transport
• Herline A Knights, R.D, LD
• Jonathan E. Koontz, PT
• David Foster Kritzberg, D.C.

• Clinical Social Worker in Covington, GA
• Providers in Covington, 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 Jan 31, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.