Individual provider Active NPI

Regina Yvette Scruggs, LCSW, MS

  • Clinical Social Worker
  • Valdosta, GA
National Provider Identifier
1043332166
Registry record updated May 28, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
CSW005571 Issued in GA
Practice address
100 N Patterson St Ste 50
Valdosta, GA 31601-5570
Phone
(229) 834-5452
NPI assigned
Apr 6, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 28, 2024

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X CSW005571 GA Primary

Addresses

Primary practice location

100 N Patterson St Ste 50
Valdosta, GA 31601-5570

Mailing address

100 N Patterson St Ste 50
Valdosta, GA 31601-5570
Phone (229) 834-5452

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)
Enrolled
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
CSW005571GAMDClinical Social Worker

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1175817600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1716854400000",
    "number": "1043332166",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 N PATTERSON ST STE 50",
            "city": "VALDOSTA",
            "state": "GA",
            "postal_code": "316015570",
            "telephone_number": "229-834-5452"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 N PATTERSON ST STE 50",
            "city": "VALDOSTA",
            "state": "GA",
            "postal_code": "316015570",
            "telephone_number": "229-834-5452"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SCRUGGS",
        "first_name": "REGINA",
        "middle_name": "YVETTE",
        "name_prefix": "Ms.",
        "credential": "LCSW, MS",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-04-06",
        "last_updated": "2024-05-28",
        "certification_date": "2024-05-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "GA",
            "license": "CSW005571",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Valdosta, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 28, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.