Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Ebony C Booker, LCSW

Individual provider Clinical Social Worker · NPI 1689288045

Ebony C Booker, LCSW is a Clinical Social Worker in College Park, Georgia. Graduated from Fordham University School of Medicine in 1999, 27 years ago. Practices with The Southeast Permanente Medical Group, a 826-clinician group and accepts Medicare assignment. Licensed in Georgia.

Years since qualifying
27
Trained at
Fordham University School of Medicine
Licensed in
GA
In the registry since
2020
What do these letters mean?
LCSW — Licensed Clinical Social Worker
A social worker licensed to diagnose and treat mental health conditions independently.

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Practice location Address checks out

135 Alicante St
College Park, GA 30349-8493
Phone: (404) 707-5743
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Clinical Social Worker (primary) Taxonomy 1041C0700X · Licence CSW006762 (GA)

Record details

NPI number1689288045
Entity typeIndividual (Type 1)
GenderFemale
Credentials LCSW
Sole proprietorNo
NPI enumeratedSeptember 3, 2020
Last updated in NPPESSeptember 3, 2020
Certification dateSeptember 3, 2020
Mailing address135 Alicante St, College Park, GA 30349-8493

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyCLINICAL SOCIAL WORKER
Medical schoolFORDHAM UNIVERSITY SCHOOL OF MEDICINE
Graduated 1999 (27 years in practice)
Group practice The Southeast Permanente Medical Group — 826 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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