PHYLLIS J JETER (LCSW) – Clinical Social Worker, NPI 1437100484

PHYLLIS J JETER (LCSW) is a healthcare provider. based in Albany, Georgia. specializing in Clinical Social Worker. They hold the professional credentials LCSW. They hold a License No. CSW002331 (GA). The NPI Number for PHYLLIS J JETER (LCSW) is 1437100484

Main info

Female
46 Years Of Experience
Accepts Medicare Assignment
Name
PHYLLIS J JETER (LCSW)
NPI
1437100484
Phone
(229) 312-7001
Address
910 N Jefferson St
Enumeration Date
15 May 2006
Last Update Date
16 October 2019

Doctor Profile

Medical School Name
OTHER
Secondary Phone
9107429243
Graduation Year
1980 (46 years ago)
PAC ID
6901816743
Group Practice PAC ID
7416132428
Professional Enrollment ID
I20060425000215
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience54
Completeness75
Years active:20State licenses:1Digital endpointsOther names

Provider Addresses for PHYLLIS J JETER (LCSW)

  • 910 N Jefferson St

    Albany, GA 317012393

    Phone: (229) 312-7001

    Fax: (229) 312-7006

    Type: Location

  • Rice Box, Atlanta BeltLine Eastside Trail, Atlanta, Fulton County, Georgia, 30308, United States

    ATLANTA, GA 303538622

    Phone: (910) 535-1211

    Fax: (919) 746-7603

    Type: Mailing

  • 1345, Redmond Circle, Rome, Floyd County, Georgia, 30165, United States

    ROME, GA 301651307

    Phone: (910) 742-9243

    Fax: (888) 746-1787

    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: 2006-04-25

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20060425000215IClinical Social WorkerGATBD

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.

Verify on CMS Revalidation Lookup Tool

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 31701)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 7416132428View full group profile

Reviews

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Frequently asked questions

What is the registry number for PHYLLIS J JETER (LCSW)?
The registry entry for PHYLLIS J JETER (LCSW) shows NPI 1437100484.
Is PHYLLIS J JETER (LCSW)'s NPI status active today?
Active status means PHYLLIS J JETER (LCSW)'s NPI record is not deactivated in the public file.
What services align with PHYLLIS J JETER (LCSW)'s listing?
PHYLLIS J JETER (LCSW)'s public classification highlights Clinical Social Worker. Clinical services aligned with this taxonomy classification.
What city is tied to PHYLLIS J JETER (LCSW)?
The directory associates PHYLLIS J JETER (LCSW) with Albany, Georgia. Check all listed addresses for suites or satellite offices.
Who maintains PHYLLIS J JETER (LCSW)'s record?
Providers certify NPPES data; CMS hosts the public file you are viewing.

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