Active NPI
Jerry Lee Allred Jr., LISW-CP
- Clinical Social Worker
- Sumter, SC
National Provider Identifier
1003590340
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 6824
- Practice address
- 11 Crosswell Dr
Sumter, SC 29150-3611 - Phone
- (803) 803-6511
- NPI assigned
- Jun 14, 2023
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 6824 | SC | Primary |
Addresses
Primary practice location
11 Crosswell Dr
Sumter, SC 29150-3611
Mailing address
11 Crosswell Dr
Sumter, SC 29150-3611
Phone (803) 651-1300
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 6824 | SC | MD | Speech-Language Pathologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1686700800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1686700800000",
"number": "1003590340",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "11 CROSSWELL DR",
"city": "SUMTER",
"state": "SC",
"postal_code": "291503611",
"telephone_number": "803-651-1300",
"fax_number": "803-774-6442"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "11 CROSSWELL DR",
"city": "SUMTER",
"state": "SC",
"postal_code": "291503611",
"telephone_number": "803-803-6511"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ALLRED",
"first_name": "JERRY",
"middle_name": "LEE",
"name_prefix": "Mr.",
"name_suffix": "Jr.",
"credential": "LISW-CP",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2023-06-14",
"last_updated": "2023-06-14",
"certification_date": "2023-06-14",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "SC",
"license": "6824",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Sumter, SC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 14, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.