Kim Pogue, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

CSW002645 Issued in GA

Practice address

48 Main St
Suite 3a
Senoia, GA 30276-1895

Phone

(678) 723-0400

Fax

(770) 599-9779

NPI assigned

Mar 11, 2016

Sex

Female

Sole proprietor

No

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

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 and National Provider Directory roles.

• Palmetto Health Council Inc

  • Federally Qualified Health Center (FQHC)
  • Palmetto, GA
  • NPI 1184884678
  Medicare reassignment NPD

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

{
    "created_epoch": "1457654400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1458691200000",
    "number": "1962863431",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "643 MAIN ST",
            "city": "PALMETTO",
            "state": "GA",
            "postal_code": "302681138"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "48 MAIN ST",
            "address_2": "SUITE 3A",
            "city": "SENOIA",
            "state": "GA",
            "postal_code": "302761895",
            "telephone_number": "678-723-0400",
            "fax_number": "770-599-9779"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "POGUE",
        "first_name": "KIM",
        "name_prefix": "Mrs.",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-03-11",
        "last_updated": "2016-03-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "GA",
            "license": "CSW002645",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Paraclete Christian Counseling and Educational Services
• Leslie Isabel Perez, M.D.
• Michael Stuart Perry, M.A., L.P.C., N.C.C.
• Tina Renee Phillips
• Phoenix Rising Behavioral Health, LLC
• Publix Super Markets, Inc
• Redwood Counseling LLC
• Rock Surgical LLC
• Royal Haven Home Care Services
• Teki Mashawn Russell, OTR/L

• Clinical Social Worker in Senoia, GA
• Providers in Senoia, 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 Mar 23, 2016; 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.