Individual provider Active NPI

Warren Phillips, LMSW

  • Social Worker
  • Mount Pleasant, SC
National Provider Identifier
1063081255
Registry record updated Jun 22, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
License
12856 Issued in SC
Practice address
1470 Ben Sawyer Blvd Ste 6
Mount Pleasant, SC 29464-4593
Phone
(843) 352-9982
NPI assigned
Jun 22, 2021
Last updated
Jun 22, 2021By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 22, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X 12856 SC Primary

Addresses

Primary practice location

1470 Ben Sawyer Blvd Ste 6
Mount Pleasant, SC 29464-4593

Mailing address

667 Adluh St
Mount Pleasant, SC 29464-4462
Phone (314) 603-3492

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL warren@lantanarecovery.com Lantana Recovery

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

LicenseStateTypeSpecialty
12856SCMDSports Medicine (Internal Medicine) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Lantana Recovery CurrentSince Jun 27, 2021 Accepting new patients
Lantana Psychiatry LLC CurrentSince Jul 17, 2021 Accepting new patients

Locations

1470 Ben Sawyer Blvd
Ste 6
Mt Pleasant, SC 29464
Phone (843) 352-9982

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1624320000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1624320000000",
    "number": "1063081255",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "667 ADLUH ST",
            "city": "MOUNT PLEASANT",
            "state": "SC",
            "postal_code": "294644462",
            "telephone_number": "314-603-3492"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1470 BEN SAWYER BLVD STE 6",
            "city": "MOUNT PLEASANT",
            "state": "SC",
            "postal_code": "294644593",
            "telephone_number": "843-352-9982"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PHILLIPS",
        "first_name": "WARREN",
        "credential": "LMSW",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2021-06-22",
        "last_updated": "2021-06-22",
        "certification_date": "2021-06-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "SC",
            "license": "12856",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "warren@lantanarecovery.com",
            "affiliation": "Y",
            "affiliationName": "Lantana Recovery",
            "address_1": "1470 Ben Sawyer Blvd Ste 6",
            "city": "Mount Pleasant",
            "state": "SC",
            "country_code": "US",
            "postal_code": "294644593",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Mount Pleasant, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 22, 2021; 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.