PHYLLIS J JETER (NPI# 1437100484) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1437100484 |
| Entity Type | Individual |
| Full Name | PHYLLIS J JETER |
| Credential | LCSW |
| Practice Address |
1345 Redmond Cir Nw Rome GA 30165-1307 |
| Mailing Address |
Po Box 538622 Atlanta GA 30353-8622 |
| Practice Telephone | 9107429243 |
| Practice Fax Number | 8887461787 |
| Mailing Telephone | 9105351211 |
| Mailing Fax Number | 9197467603 |
| Enumeration Date | 2006-05-15 |
| Last Update Date | 2019-10-16 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1041C0700X |
Social Worker Specialization: Clinical |
CSW002331 | GA | Behavioral Health & Social Service Providers |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 910 N Jefferson St, Albany, GA 317012393 | 2293127001 | 2293127006 |
| Street Address |
1345 REDMOND CIR NW |
| City | ROME |
| State | GA |
| Zip Code | 30165-1307 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1265064455 | Aubrie Kreft | Physical Therapist | 1345 Redmond Cir Nw, Rome, GA 30165-1307 | 2020-02-06 |
| 1275182024 | Analyn Castanar | Occupational Therapist | 1345 Redmond Cir Nw, Rome, GA 30165-1307 | 2019-09-04 |
| 1801444260 | Jennifer Iverson | Social Worker | 1345 Redmond Cir Nw, Rome, GA 30165-1307 | 2019-08-29 |
| 1912477266 | Sarah Pickering | Physical Therapist | 1345 Redmond Cir Nw, Rome, GA 30165-1307 | 2018-11-29 |
| 1225508542 | Breonna Leon | Nurse Practitioner | 1345 Redmond Cir Nw, Rome, GA 30165-1307 | 2018-11-29 |
| 1962940817 | Lifesource of North Carolina | Psychologist | 1345 Redmond Cir Nw, Rome, GA 30165-1307 | 2017-02-10 |
| 1669801551 | Barbara Rubin | Psychologist | 1345 Redmond Cir Nw, Rome, GA 30165-1307 | 2013-11-01 |
| 1104051168 | Tresselyn Douglas Adams | Nurse Practitioner | 1345 Redmond Cir Nw, Rome, GA 30165-1307 | 2009-05-20 |
| 1437101607 | Ggnsc Rome LLC | Skilled Nursing Facility | 1345 Redmond Cir Nw, Rome, GA 30165-1307 | 2006-05-16 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1346868775 | Heather Bowman | Physical Therapist | 600 Eagle, E Lake Dr, Rome, GA 30165 | 2020-07-13 |
| 1205451101 | Kristopher Nelson | Student in an Organized Health Care Education/Training Program | 4256, 304 Shorter Ave Nw #201, Rome, GA 30165 | 2020-06-16 |
| 1962061457 | Stuart Paul Shaklee | Occupational Therapy Assistant | 1356 Redmond Road, Rome, GA 30165 | 2019-06-10 |
| 1386001055 | Autumn Streetman | Counselor | 6 Mathis Drive, Rome, GA 30165 | 2016-01-26 |
| 1144695784 | Gabrador Milligan | Counselor | 6 Mathis Road, Rome, GA 30165 | 2015-12-08 |
| 1386041952 | Theresa Suits | Registered Nurse | 1 Woodbine Avenue, Rome, GA 30165 | 2014-11-26 |
| 1942561147 | Nicole C. Christian | Clinical Neuropsychologist | 305 Redmond Rd, Rome, GA 30165 | 2012-06-04 |
| 1679832711 | Niki Pareshkumar Bhavsar | Internal Medicine | 3041 Turner Mccall Blvd, Rome, GA 30165 | 2012-05-10 |
| 1285927491 | Amanda Fischer Reeves | Family Medicine | 304 Shorter Ave Nw Ste 102, Rome, GA 30165 | 2011-05-20 |
| 1033436647 | Northland Hearing Centers, Inc. | Hearing Instrument Specialist | 4 Coosawattee Ave, Rome, GA 30165 | 2010-04-23 |
| Find all providers in zip 30165 | ||||
| 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 |
|---|---|---|---|---|
| 1255946976 | Lisa Kaelin | Social Worker | 1513 Craig St, Rome, NY 13440-2305 | 2020-09-10 |
| 1861003337 | Eamon O Dowling | Social Worker | 6 Mathis Dr Nw Ste B, Rome, GA 30165-1242 | 2020-08-10 |
| 1245721489 | Amanda Kay Krzemien | Social Worker | 125 Brookley Road Syracuse Department of Veterans Affai, Suite 1204, Rome, NY 13341 | 2018-05-23 |
| 1649601881 | Stephanie Franklin | Social Worker | 1349 Redmond Cir Nw Apt E2, Rome, GA 30165-1342 | 2013-12-12 |
| 1467898296 | Charlene M Seal, Lcsw, LLC | Social Worker | 2 Pear St, Rome, GA 30161-1711 | 2013-05-20 |
| 1588968150 | Susan Robinson | Social Worker | 1345 Redmond Rd, Rome, GA 30165-1307 | 2010-12-22 |
| 1760708689 | Sally Anne Fontana | Social Worker | 227 W Dominick St, Rome, NY 13440-5853 | 2010-04-16 |
| 1518122811 | Brooke Robillard | Social Worker | 5 Leon St Sw, Rome, GA 30165-4021 | 2008-07-25 |
| 1487833802 | Heather Marie Erb | Social Worker | 2096 Martha Berry Hwy Ne, Rome, GA 30165-1646 | 2007-11-01 |
| 1558569160 | Francis Anthony Novak Jr. | Social Worker | Griffis Park 125 Brookley Rd, Donald J Mitchell V.a. Outpatient Clinic, Rome, NY 13440 | 2007-07-05 |
| Find all providers in ROME | ||||
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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.