Individual provider Active NPI

Maryanne Zabrycki

  • Clinical Social Worker
  • North Myrtle Beach, SC
National Provider Identifier
1063561082
Registry record updated Jun 21, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
14286 Issued in SC
Practice address
1016 2ND Ave N Ste 205
North Myrtle Beach, SC 29582-3288
Phone
(843) 491-3344
NPI assigned
Jan 9, 2007
Last updated
Jun 21, 2023By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 21, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social WorkerGroup: 193400000X SINGLE SPECIALTY GROUP 1041C0700X 14286 SC Primary

Addresses

Primary practice location

1016 2ND Ave N Ste 205
North Myrtle Beach, SC 29582-3288

Mailing address

1016 2ND Ave N Ste 205
North Myrtle Beach, SC 29582-3288
Phone (843) 491-3344

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SC
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20241213000663 SC Practitioner - Clinical Social Worker 1153857198 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1980
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Etheria Counseling LLCGroup PAC ID 0547793978, 5 clinicians

Practice addresses (Care Compare)

1551 21St Ave N
Suite 17
Myrtle Beach, SC 29577-7496
Phone (843) 868-6200

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
14286SCMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Etheria Counseling LLC Clinical CurrentSince Oct 17, 2024 Accepting new patients

Locations

1551 21st Ave N
Ste 17
Myrtle Beach, SC 29577
Phone (843) 868-6200

Organizations & group practices 1

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": "1168300800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1687305600000",
    "number": "1063561082",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1016 2ND AVE N STE 205",
            "city": "NORTH MYRTLE BEACH",
            "state": "SC",
            "postal_code": "295823288",
            "telephone_number": "843-491-3344"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1016 2ND AVE N STE 205",
            "city": "NORTH MYRTLE BEACH",
            "state": "SC",
            "postal_code": "295823288",
            "telephone_number": "843-491-3344"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ZABRYCKI",
        "first_name": "MARYANNE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-01-09",
        "last_updated": "2023-06-21",
        "certification_date": "2023-06-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Social Worker, Clinical",
            "state": "SC",
            "license": "14286",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in North Myrtle Beach, SC

Sources for this page

Verify at the official NPI Registry.