Active NPI
Julius Lashame Jessup Peterson, LCSW
- Clinical Social Worker
- Decatur, GA
National Provider Identifier
1932330149
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- CSW005018
- Practice address
- 209A Swanton Way Ste 202
Decatur, GA 30030-3271 - Phone
- (404) 626-2976
- NPI assigned
- Aug 5, 2009
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | CSW005018 | GA | Primary |
Addresses
Primary practice location
209A Swanton Way Ste 202
Decatur, GA 30030-3271
Mailing address
209A Swanton Way Ste 202
Decatur, GA 30030-3271
Phone (404) 626-2976
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)
- Enrolled
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Teladoc Health Medical Group, P.a. | Clinical | Current | Accepting new patients |
Interoperability endpoints
- juliusjessuppeterson@tdh.allscriptsdirect.net
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": "1249430400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1523923200000",
"number": "1932330149",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "209A SWANTON WAY STE 202",
"city": "DECATUR",
"state": "GA",
"postal_code": "300303271",
"telephone_number": "404-626-2976"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "209A SWANTON WAY STE 202",
"city": "DECATUR",
"state": "GA",
"postal_code": "300303271",
"telephone_number": "404-626-2976"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JESSUP PETERSON",
"first_name": "JULIUS",
"middle_name": "LASHAME",
"credential": "LCSW",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2009-08-05",
"last_updated": "2018-04-17",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "GA",
"license": "CSW005018",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Decatur, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 17, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.