Individual provider Active NPI

Kabian Brown, LCSW

  • Clinical Social Worker
  • Conyers, GA
National Provider Identifier
1942677901
Registry record updated Apr 17, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
005953 Issued in GA
Practice address
1506 Klondike Rd SW
Ste 403
Conyers, GA 30094-5173
Phone
(404) 333-7725
Fax
(678) 609-0592
NPI assigned
Aug 26, 2015
Last updated
Apr 17, 2019By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 17, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X 726 CT
Clinical Social Worker 1041C0700X 005953 GA Primary

Addresses

Primary practice location

1506 Klondike Rd SW
Ste 403
Conyers, GA 30094-5173

Mailing address

1506 Klondike Rd SW
Ste 403
Conyers, GA 30094-5173
Phone (404) 333-7725

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
I20190514003276 GA Practitioner - Clinical Social Worker 1759624760 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
005953GAMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Advantage Behavioral Health Systems CurrentSince Feb 1, 2026 Accepting new patients
Sos Counseling and Consultation Group, LLC PastSince Jan 12, 2020 Accepting new patients

Locations

250 Bray St
Athens, GA 30601
Phone (706) 542-9746

240 Mitchell Bridge Rd
Athens, GA 30606
Phone (706) 389-6767

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1440547200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1555459200000",
    "number": "1942677901",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1506 KLONDIKE RD SW",
            "address_2": "STE 403",
            "city": "CONYERS",
            "state": "GA",
            "postal_code": "300945173",
            "telephone_number": "404-333-7725",
            "fax_number": "678-609-0592"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1506 KLONDIKE RD SW",
            "address_2": "STE 403",
            "city": "CONYERS",
            "state": "GA",
            "postal_code": "300945173",
            "telephone_number": "404-333-7725",
            "fax_number": "678-609-0592"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BROWN",
        "first_name": "KABIAN",
        "name_prefix": "Mr.",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2015-08-26",
        "last_updated": "2019-04-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "CT",
            "license": "726",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "GA",
            "license": "005953",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Conyers, GA

Sources for this page

Verify at the official NPI Registry.