Active NPI
Consuela Delores Douglas
- Social Worker
- Atlanta, GA
National Provider Identifier
1982131983
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Social Worker
- License
- MSW003163
- Practice address
- 1040 Boulevard SE
Atlanta, GA 30312-3811 - Phone
- (404) 441-7967
- NPI assigned
- May 22, 2017
- Sex
- Female
- 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 |
|---|---|---|---|---|
| Social Worker | 104100000X | MSW003163 | GA | Primary |
Addresses
Primary practice location
1040 Boulevard SE
Atlanta, GA 30312-3811
Mailing address
2423 Cheyenne CT
Douglasville, GA 30135-8113
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| MSW003163 | GA | MD | Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1495411200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1495411200000",
"number": "1982131983",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2423 CHEYENNE CT",
"city": "DOUGLASVILLE",
"state": "GA",
"postal_code": "301358113"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1040 BOULEVARD SE",
"city": "ATLANTA",
"state": "GA",
"postal_code": "303123811",
"telephone_number": "404-441-7967"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DOUGLAS",
"first_name": "CONSUELA",
"middle_name": "DELORES",
"name_prefix": "Mrs.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2017-05-22",
"last_updated": "2017-05-22",
"status": "A"
},
"taxonomies": [
{
"code": "104100000X",
"taxonomy_group": "",
"desc": "Social Worker",
"state": "GA",
"license": "MSW003163",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Atlanta, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 22, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.