MS. JASMINE V MCCULLY (LCSW) – Clinical Social Worker, NPI 1114475563
Clinical Social Worker
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
1,046 CLINICAL SOCIAL WORKER in GA
Provider Addresses for MS. JASMINE V MCCULLY (LCSW)
5864 SUMMERGIEN LANE
COLLEGE PARK, GA 30349
Phone: (219) 484-5904
Fax: (888) 773-1428
Type: Location
90265, Rua Vale do Siriji, Areeiro, Camaragibe, Região Geográgica Imediata do Recife, Região Metropolitana do Recife, Pernambuco, Northeast Region, 54762-165, Brazil
EAST POINT, GA 303640265
Phone: (219) 484-5904
Fax: (888) 773-1428
Type: Mailing
1835 SAVOY DR
ATLANTA, GA 303411072
Phone: (219) 484-5904
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
No Open Payments data available for this provider.
This can happen when there are no reportable CMS Open Payments records.
Medicare Enrollment & Revalidation
Source: CMS public data · Not endorsed by CMS ·
Educational use only—not medical, billing, or legal advice.
PECOS enrollment status
Participating (accepts Medicare assignment)
Enrollment effective: 2026-02-04
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Due date not assigned yet
CMS is tracking 5 Medicare enrollment records; no due dates published yet.
Enrollment records
5
Earliest due date
Not assigned (TBD)
CMS data updated
2026-06-01
Revalidation progress
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20230426001089 | I | Clinical Social Worker | IL | TBD |
| I20230725001360 | I | Clinical Social Worker | MI | TBD |
| I20250801002971 | I | Clinical Social Worker | CO | TBD |
| I20260119000202 | I | Clinical Social Worker | CA | TBD |
| I20260204004436 | I | Clinical Social Worker | OR | TBD |
What to do next
- No action required while the due date shows TBD.
- Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
- Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.
Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS
Medicare Utilization (FFS)
Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·
Educational use only—not medical, billing, or legal advice.
No Medicare fee-for-service utilization data available for this provider in our database.
Insurance plans in this area (ZIP 30349)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| Physician Assistant | NY | |
| Clinical Social Worker | NJ | |
| Clinical Social Worker | NJ | |
| Nurse Practitioner | NY | |
| Nurse Practitioner | ON | |
| Nurse Practitioner | NY | |
| Clinical Social Worker | NY | |
| Physician Assistant | NY | |
| Nurse Practitioner | NY | |
| P S Y C H I A T R Y | NJ |
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