MRS. RUTUBULA PETTAWAY (NPI# 1588290670) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1588290670 |
| Entity Type | Individual |
| Full Name | MRS. RUTUBULA PETTAWAY |
| Credential | LCSW |
| Practice Address |
1046 Ridge Ave Sw Atlanta GA 30315-1640 |
| Mailing Address |
2238 Nantucket Ct Ne Marietta GA 30066-2128 |
| Practice Telephone | 4045646942 |
| Mailing Telephone | 9046102534 |
| Enumeration Date | 2020-03-20 |
| Last Update Date | 2020-03-20 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1041C0700X |
Social Worker Specialization: Clinical |
CSW006936 | GA | Behavioral Health & Social Service Providers |
| Street Address |
1046 RIDGE AVE SW |
| City | ATLANTA |
| State | GA |
| Zip Code | 30315-1640 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1235123993 | Southside Medical Center, Inc. | Clinic/Center | 1046 Ridge Ave Sw, Atlanta, GA 30315-1640 | 2005-09-08 |
| 1902427669 | Jacqueline Hamilton | Dietitian, Registered | 1046 Ridge Ave Sw, Atlanta, GA 30315-1640 | 2020-05-04 |
| 1063975944 | Donnamarie Wilson | Registered Nurse | 1046 Ridge Ave Sw, Atlanta, GA 30315 | 2019-04-09 |
| 1225598030 | Joi Raines | Nurse Practitioner | 1046 Ridge Ave Sw, Atlanta, GA 30315-1640 | 2019-03-20 |
| 1417432006 | Taylor Breann Gonzalez | Advanced Practice Midwife | 1046 Ridge Ave Sw, Atlanta, GA 30315-1640 | 2018-09-28 |
| 1154810299 | Keli Chapman | Midwife | 1046 Ridge Ave Sw, Atlanta, GA 30315-1640 | 2018-05-03 |
| 1730680992 | Dena Boykin | Dental Hygienist | 1046 Ridge Ave Sw, Atlanta, GA 30315-1640 | 2018-02-23 |
| 1063913234 | Sadaf Rehmani | Dental Hygienist | 1046 Ridge Ave Sw, Atlanta, GA 30315-1640 | 2018-02-23 |
| 1629519251 | Anita Khimani | Clinic/Center | 1046 Ridge Ave Sw, Atlanta, GA 30315-1640 | 2017-03-15 |
| 1750821997 | Faith Jean-louis | Nurse Practitioner | 1046 Ridge Ave Sw, Atlanta, GA 30315-1640 | 2017-03-07 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1083181341 | Erin Cole | Specialist/Technologist | Lakewood Ave Se, Atlanta, GA 30315 | 2018-10-25 |
| 1942701081 | Julie Crocker | Dental Hygienist | 1046 Ridge Ave. Sw, Atlanta, GA 30315 | 2018-02-23 |
| 1457695850 | Dominica Aquino Morales-gibson | Physical Therapist | 2850 Springdale Road Sw, Atlanta, GA 30315 | 2012-11-26 |
| 1912264813 | Maxwell Uhakheme | Internal Medicine | 6875 Douglas Blvd, Suite A, Kaiser Permanente Douglasville Medical Center, Douglasville, GA 30315 | 2012-04-16 |
| 1427329093 | Sulonda Smith | Counselor | 34 Atlanta Ave. Se, Hank Aaron Blvd, Atlanta, GA 30315 | 2012-01-13 |
| 1407152507 | Gerald Leroy Griffin | Pharmacist | 520 Boulevard, Atlanta, GA 30315 | 2011-02-07 |
| 1245404854 | Tunisia Finch Cornelius | Dermatology | 1039 Grant St Se Ste A-11, Atlanta, GA 30315 | 2008-04-15 |
| 1356512180 | Chandra Blakely | Counselor | 215 Lakewood Way, Suite 205, Atlanta, GA 30315 | 2008-03-19 |
| 1104043967 | Alvin H. Clair, M.d.p.c. | Dermatology | 777 Cleveland Ave.,sw Ste.500, Atlanta, GA 30315 | 2007-04-20 |
| 1396877742 | Scott M Russell | Speech-Language Pathologist | 1364 Clifton Road, Atlanta, GA 30315 | 2007-03-12 |
| Find all providers in zip 30315 | ||||
| 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 |
|---|---|---|---|---|
| 1023617495 | Anita S White | Social Worker | 981 Cleveland Ave, Atlanta, GA 30344-6717 | 2020-10-18 |
| 1164038394 | Alex Kyle Allen | Social Worker | 10 Surry County Pl Nw, Atlanta, GA 30318-1412 | 2020-09-22 |
| 1679189872 | Nicole Melissa King | Social Worker | 130 Arizona Ave Ne Unit 408, Atlanta, GA 30307-2257 | 2020-09-22 |
| 1245845288 | Jennie Gray Mulligan | Social Worker | 1911 Hallman St Ne, Atlanta, GA 30317-1001 | 2020-09-15 |
| 1518577253 | Chastity Quave | Social Worker | 790 Huff Rd Nw Apt 2062, Atlanta, GA 30318-4344 | 2020-08-07 |
| 1407465354 | Lavender Grove Psychotherapy | Social Worker | 3755 Redwine Rd, Atlanta, GA 30344-5899 | 2020-07-27 |
| 1861001174 | Whitney Flemister | Social Worker | 3961 Princeton Lakes Way Sw, Atlanta, GA 30331 | 2020-07-23 |
| 1518576883 | Dream Again Therapy Services LLC | Social Worker | 3401 Norman Berry Dr Ste 254a, Atlanta, GA 30344-5102 | 2020-07-23 |
| 1245848878 | Chalon Dabney | Social Worker | 1155 Perimeter Ctr, Atlanta, GA 30338-5463 | 2020-07-20 |
| 1649888595 | Adrienne Bryant Smith | Social Worker | 2099 Glenwood Ave Se, Atlanta, GA 30316-2358 | 2020-07-16 |
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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.