Active NPI
Kenneth Andrew Harrell, LCSW
- Clinical Social Worker
- Macon, GA
National Provider Identifier
1982809331
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- CSW003458
- Practice address
- 117 Parkwood Ave
Macon, GA 31210-5018 - Phone
- (478) 477-2220
- NPI assigned
- Jun 17, 2007
- 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 | CSW003458 | GA | Primary |
Addresses
Primary practice location
117 Parkwood Ave
Macon, GA 31210-5018
Mailing address
114 Peachtree Blvd
Bonaire, GA 31005-4040
Phone (478) 218-4646
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| CSW003458 | GA | MD | Clinical Social Worker |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Piedmont Counseling Services, Inc. | Past | Accepting new patients |
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.
-
- Community/Behavioral Health Agency
- Macon, GA
- NPI 1922292002
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1182038400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1982809331",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "114 PEACHTREE BLVD",
"city": "BONAIRE",
"state": "GA",
"postal_code": "310054040",
"telephone_number": "478-218-4646"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "117 PARKWOOD AVE",
"city": "MACON",
"state": "GA",
"postal_code": "312105018",
"telephone_number": "478-477-2220"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HARRELL",
"first_name": "KENNETH",
"middle_name": "ANDREW",
"credential": "LCSW",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2007-06-17",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "GA",
"license": "CSW003458",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Macon, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.