MRS. JODI ELLEN FORMAN (NPI# 1245396217) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1245396217 |
| Entity Type | Individual |
| Full Name | MRS. JODI ELLEN FORMAN |
| Credential | LCSW |
| Practice Address |
122 Cherry St Ne Marietta GA 30060-7206 |
| Practice Telephone | 4042724261 |
| Practice Fax Number | 7704222302 |
| Mailing Telephone | 4042724261 |
| Mailing Fax Number | 7704222302 |
| Enumeration Date | 2006-12-27 |
| Last Update Date | 2007-07-08 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1041C0700X |
Social Worker Specialization: Clinical |
2835 | GA | Behavioral Health & Social Service Providers |
| Street Address |
122 CHERRY ST NE |
| City | MARIETTA |
| State | GA |
| Zip Code | 30060-7206 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1780614636 | Susan Z. Volentine | Psychologist | 122 Cherry St Ne, Marietta, GA 30060-7206 | 2006-07-04 |
| 1407197908 | Townsend Psychology | Psychologist | 122 Cherry St Ne, Marietta, GA 30060-7206 | 2013-03-07 |
| 1558516336 | Edwin W. Nash Jr. | Counselor | 122 Cherry St Ne, Marietta, GA 30060-7206 | 2008-11-20 |
| 1376728394 | Psychological Affiliates | Social Worker | 122 Cherry St Ne, Marietta, GA 30060-7206 | 2008-01-09 |
| 1386845923 | Jill Allweiss | Social Worker | 122 Cherry St Ne, Marietta, GA 30060-7206 | 2007-05-30 |
| 1194851253 | Margaret Ann Brown | Counselor | 122 Cherry St Ne, Marietta, GA 30060-7206 | 2007-02-25 |
| 1093869174 | Daniel Thomas Rogers | Psychologist | 122 Cherry St Ne, Marietta, GA 30060-7206 | 2007-01-23 |
| 1376692061 | Jack Holland Grisham | Psychologist | 122 Cherry St Ne, Marietta, GA 30060-7206 | 2007-01-10 |
| 1245380716 | Judith 'dee' Cobb | Social Worker | 122 Cherry St Ne, Marietta, GA 30060-7206 | 2007-01-10 |
| 1225190796 | Imogene Hays Brodsky | Social Worker | 122 Cherry St Ne, Marietta, GA 30060-7206 | 2006-12-14 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1144845116 | Legacy Center for Spinal Surgery, LLC | Neurological Surgery | 1900 The Exchange, Ne, Suite 600, Marietta, GA 30060 | 2020-06-15 |
| 1407477193 | Michael Cynil Daniel | Counselor | 698 N Marietta, Pkwy, Marietta, GA 30060 | 2020-05-04 |
| 1285253401 | Cameron Thomas Kennelly | Student in an Organized Health Care Education/Training Program | 677 Church Street Ne Attn:gme, Marietta, GA 30060 | 2020-04-09 |
| 1922640739 | Jeremiah George Blair | Physician Assistant | 61 Whitcher St Suite 2100, Marietta, GA 30060 | 2019-10-14 |
| 1164064945 | Denise Alicia Mick | Registered Nurse | 677 Church St Wellstar Kennestone Hospital, Marietta, GA 30060 | 2019-10-12 |
| 1184283772 | Iora Health Georgia, P.C. | Internal Medicine | 280 Cobb Pkwy Se, Suite 60, Marietta, GA 30060 | 2019-06-07 |
| 1346703212 | Caitlin Virginia Mueller | Student in an Organized Health Care Education/Training Program | 677 Church Street Ne, Attn: Gme, Marietta, GA 30060 | 2019-04-08 |
| 1184187205 | Adero Francis | Student in an Organized Health Care Education/Training Program | Wellstar Kennestone Gme Internal Medicine Clinic, 833 Campbell Hill St Nw, Suite 250, Marietta, GA 30060 | 2019-04-08 |
| 1659832749 | Matthew Mozzo | Student in an Organized Health Care Education/Training Program | 677 Church Street / Lower Level, Gme Department / I.m., Marietta, GA 30060 | 2019-03-29 |
| 1245797430 | La'myia Spentz | Specialist | 109 Anderson St Ne, Suite 608, Marietta, GA 30060 | 2019-02-25 |
| Find all providers in zip 30060 | ||||
| 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 |
|---|---|---|---|---|
| 1619578051 | Pamela D Kretzmer | Social Worker | 3855 Shallowford Road, Suite 420, Marietta, GA 30062 | 2020-11-03 |
| 1659988434 | Jessica Ochei | Social Worker | 2546 Telfair Pl Ne, Marietta, GA 30062-4444 | 2020-09-25 |
| 1760010490 | Christina Patricia Neri | Social Worker | 1803 Tilliewood Trl Ne, Marietta, GA 30066-2968 | 2020-03-30 |
| 1083247787 | Colleen Sandick | Social Worker | 4330 Cornwallis Ct Ne, Marietta, GA 30068-2709 | 2020-02-20 |
| 1073159034 | Magdala Tulcie Jodesty-jackson | Social Worker | 4343 Shalloword Road, Building H, Suite 4 Lower Level, Marietta, GA 30062 | 2019-11-25 |
| 1528601143 | Angela Caldwell-lawson | Social Worker | 1584 Park Brooke Cir Sw, Marietta, GA 30008-5308 | 2019-10-27 |
| 1093357006 | Katherine Kenreich | Social Worker | 1744 Roswell Rd Ste 215, Marietta, GA 30062-3979 | 2019-10-10 |
| 1841842283 | Essential Matters Counseling & Therapy, LLC | Social Worker | 2453 Powder Springs Rd Sw Ste 225c, Marietta, GA 30064-4570 | 2019-07-16 |
| 1801454731 | Laura Beth Rifkin | Social Worker | 273 Shaded Oaks Ln Se, Marietta, GA 30067-7440 | 2019-06-05 |
| 1952866006 | Marietta Counseling Practice | Social Worker | 142 S Park Sq Ne, Marietta, GA 30060-8616 | 2019-02-03 |
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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.