Juliet Ihedike, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

CSW007463 Issued in GA

Practice address

110 Evans Mill Dr Ste 305
Dallas, GA 30157-1623

Phone

(678) 348-6390

Fax

(678) 550-6380

NPI assigned

Apr 9, 2012

Last updated

Aug 28, 2022By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other names 1

• Juliet Ifeobu Former name

Electronic endpoints 2

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

Medicare enrollment (NPD)

Enrolled

State licenses

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Tranquil Point Connections, LLC

  • Mental Health Counselor
  • Dallas, GA
  • NPI 1881357093
  Medicare reassignment NPD Authorized official
• Highland Rivers Community Service Board

  • Community/Behavioral Health Agency
  • Dalton, GA
  • NPI 1447256243
  Medicare reassignment NPD
• The Northrop Connection, LLC

  • Clinical Social Worker
  • Dallas, GA
  • NPI 1912398868
  Medicare reassignment NPD
• Highland Rivers CSB

  dba Highland Rivers Whitfield Treatment Services

  • Community/Behavioral Health Agency
  • Dalton, GA
  • NPI 1164585543
  NPD

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

{
    "created_epoch": "1333929600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1661644800000",
    "number": "1962768572",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "110 EVANS MILL DR STE 305",
            "city": "DALLAS",
            "state": "GA",
            "postal_code": "301571623",
            "telephone_number": "678-348-6390",
            "fax_number": "678-550-6380"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "110 EVANS MILL DR STE 305",
            "city": "DALLAS",
            "state": "GA",
            "postal_code": "301571623",
            "telephone_number": "678-348-6390",
            "fax_number": "678-550-6380"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "110 Evans Mill Dr Ste 306",
            "address_purpose": "LOCATION",
            "city": "Dallas",
            "state": "GA",
            "postal_code": "301571623",
            "country_code": "US",
            "telephone_number": "678-332-7955",
            "fax_number": "770-445-7262",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "IHEDIKE",
        "first_name": "JULIET",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-04-09",
        "last_updated": "2022-08-28",
        "certification_date": "2022-01-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "GA",
            "license": "CSW007463",
            "primary": true
        },
        {
            "code": "172V00000X",
            "taxonomy_group": "",
            "desc": "Community Health Worker",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "Dallas",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "EHR",
            "address_1": "110 Evans Mill Dr Ste 306",
            "city": "Dallas",
            "state": "GA",
            "country_code": "US",
            "postal_code": "301571623",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "EHR",
            "affiliation": "N",
            "address_1": "110 Evans Mill Dr Ste 306",
            "city": "Dallas",
            "state": "GA",
            "country_code": "US",
            "postal_code": "301571623",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "JULIET",
            "last_name": "IFEOBU",
            "credential": "MSW",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Carrell Hughes, M.A., CCC-SLP
• Lydia Hulsey
• Quanita Huntley
• Kimberly Hunton, PHARMD, MBA, MSHA
• Christina Hyndman
• In Your Home Personal Care Services LLC
• Shannon Ashley Inci, M.D.
• Independence Path Solutions LLC
• Independent Physical Therapy of Ga, LLC
• Independent Physical Therapy of Ga, LLC

• Clinical Social Worker in Dallas, GA
• Providers in Dallas, 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 Aug 28, 2022; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.