Individual provider Active NPI

Lakeisha Hollingsworth, LMSW

  • Clinical Social Worker
  • Irmo, SC
National Provider Identifier
1063866671
Registry record updated Feb 7, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
15795 Issued in SC
Practice address
3 Autumn Woods CT
Irmo, SC 29063-8061
Phone
(803) 772-0391
NPI assigned
Apr 20, 2016
Last updated
Feb 7, 2023By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 7, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X 10182 SC
Clinical Social Worker 1041C0700X 15795 SC Primary

Addresses

Primary practice location

3 Autumn Woods CT
Irmo, SC 29063-8061

Mailing address

3 Autumn Woods CT
Irmo, SC 29063-8061
Phone (803) 546-1988

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
I20241015001259 SC Practitioner - Clinical Social Worker 5496287534 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

301 Palmetto Park Blvd
Lexington, SC 29072-7872
Phone (803) 359-3545

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
10182SCMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
South Carolina Dept of Mental Health Accounting Office CurrentSince Sep 19, 2024 Accepting new patients
South Carolina Dept of Mental Health Accounting Office Current Accepting new patients
South Carolina Dept of Mental Health Accounting Office CurrentSince Sep 19, 2024 Accepting new patients

Locations

108 Palmetto Park Blvd
Ste D
Lexington, SC 29072
Phone (803) 356-0949

215 Palmetto Park Blvd
Lexington, SC 29072
Phone (803) 756-1000

301 Palmetto Park Blvd
Lexington, SC 29072
Phone (803) 359-3545

305 Palmetto Park Blvd
Lexington, SC 29072
Phone (803) 359-7206

Organizations & group practices 3

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": "1461110400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1675728000000",
    "number": "1063866671",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3 AUTUMN WOODS CT",
            "city": "IRMO",
            "state": "SC",
            "postal_code": "290638061",
            "telephone_number": "803-546-1988"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3 AUTUMN WOODS CT",
            "city": "IRMO",
            "state": "SC",
            "postal_code": "290638061",
            "telephone_number": "803-772-0391"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOLLINGSWORTH",
        "first_name": "LAKEISHA",
        "name_prefix": "Mrs.",
        "credential": "LMSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-04-20",
        "last_updated": "2023-02-07",
        "certification_date": "2023-02-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "SC",
            "license": "10182",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "SC",
            "license": "15795",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Irmo, SC

Sources for this page

Verify at the official NPI Registry.