MS. JASMINE V MCCULLY (NPI# 1114475563) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1114475563 |
| Entity Type | Individual |
| Full Name | MS. JASMINE V MCCULLY |
| Credential | LCSW |
| Practice Address |
5864 Summergien Lane College Park GA 30349 |
| Mailing Address |
Po Box 90265 East Point GA 30364 |
| Practice Telephone | 2194845904 |
| Practice Fax Number | 8887731428 |
| Mailing Telephone | 2194845904 |
| Mailing Fax Number | 8887731428 |
| Enumeration Date | 2016-09-14 |
| Last Update Date | 2020-03-11 |
| NPI Deactivation Date | 04/27/2018 |
| NPI Reactivation Date | 2020-03-11 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1041C0700X |
Social Worker Specialization: Clinical |
CSW006990 | GA | Behavioral Health & Social Service Providers |
| Street Address |
5864 SUMMERGIEN LANE |
| City | COLLEGE PARK |
| State | GA |
| Zip Code | 30349 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1376185686 | Kmb Diagnostics | Durable Medical Equipment & Medical Supplies | 941 Flat Shoals Rd, Atlanta, GA 30349 | 2019-10-09 |
| 1114575859 | Justin Vassell | Registered Nurse | 1903 Phoenix Boulevard, Suite 200, College Park, GA 30349 | 2019-08-27 |
| 1841856663 | Kennyetta Danielle Watkins | Counselor | 1431 Riverwalk Ln, Apt. F, College Park, GA 30349 | 2019-05-16 |
| 1275002636 | Patriot Healthcare of Georgia, LLC | Family Medicine | 1587 Phoenix Boulevard, Suite 6, College Park, GA 30349 | 2018-11-15 |
| 1669971875 | Ee Consulting Solution | Case Management | 6320 Topaz Tral, Arlanta, GA 30349 | 2018-02-03 |
| 1629595640 | Shayla Bouie | Contractor | 5420 Riverdale Rd Apt D17, Atlanta, GA 30349 | 2017-08-30 |
| 1639537681 | Shelia Thornton | Counselor | 5856 Seabright Lane, Atlanta, GA 30349 | 2016-02-05 |
| 1346610177 | Joanne Resilard | Nurse Practitioner | 2931 Herron Ln Sw, Atlanta, GA 30349 | 2015-10-06 |
| 1063805091 | Southwest Atlanta Medical & Rehabilitation Clinic LLC | Family Medicine | 495 85 Circle, Suite 100, Atlanta, GA 30349 | 2015-03-16 |
| 1144619586 | Catina Hart | Social Worker | 5737 Old National Highway, Suite 300, Atlanta, GA 30349 | 2015-01-22 |
| Find all providers in zip 30349 | ||||
| Taxonomy Code | 1041C0700X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Social Worker |
| Specialization | Clinical |
| A social worker who holds a master’s or doctoral degree in social work from an accredited school of social work in addition to at least two years of post-master’s supervised experience in a clinical setting. The social worker must be licensed, certified, or registered at the clinical level in the jurisdiction of practice. A clinical social worker provides direct services, including interventions focused on interpersonal interactions, intrapsychic dynamics, and life management issues. Clinical social work services are based on bio-psychosocial perspectives. Services consist of assessment, diagnosis, treatment (including psychotherapy and counseling), client-centered advocacy, consultation, evaluation, and prevention of mental illness, emotional, or behavioral disturbances. |
| Notes: Source: National Association of Social Workers, 2008 [7/1/2009: definition modified] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1205436607 | Rachel Sherman | Social Worker | 3101 Susquehanna Hall 4200 Lehigh Rd, College Park, MD 20742-0001 | 2020-10-27 |
| 1689288045 | Ebony C Booker | Social Worker | 135 Alicante St, College Park, GA 30349-8493 | 2020-09-03 |
| 1649894007 | Social Work Foundation, Inc | Social Worker | 3707 Main St # 11-2, College Park, GA 30337-3544 | 2020-06-02 |
| 1952920514 | Harmony's Path Counseling & Wellness LLC | Social Worker | 1876 Princeton Ave Ste 200, College Park, GA 30337-3519 | 2020-04-14 |
| 1487284071 | Katherine Mae O'mailey | Social Worker | 140 Campus Drive University of Maryland, College Park, MD 20742-0001 | 2020-01-22 |
| 1316504285 | Ram Circle Counseling & Coaching | Social Worker | 7100 Baltimore Ave Ste 208, College Park, MD 20740-3638 | 2019-05-25 |
| 1285100669 | Lester Brian Koen | Social Worker | 7305 Baltimore Ave Ste 207, College Park, MD 20740-3232 | 2018-10-23 |
| 1033699418 | Megan Elizabeth Mckernan | Social Worker | 4511 Knox Rd Ste 201, College Park, MD 20740-3380 | 2018-08-15 |
| 1255828539 | Joycelia Lewis | Social Worker | 4827 Old National Hwy # 1216, College Park, GA 30337-6234 | 2018-04-23 |
| 1841644002 | Jamie Spurley | Social Worker | 4751 Best Rd Suite 400s, College Park, GA 30337-5615 | 2016-04-14 |
| Find all providers in COLLEGE PARK | ||||
| City | COLLEGE PARK |
| Zip Code | 30349 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.