Individual provider Active NPI

William John Trezza, LISW-CP

  • Clinical Social Worker
  • Aiken, SC
National Provider Identifier
1073524013
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
4190 Issued in SC
Practice address
215 Barnwell Ave NW
Aiken, SC 29801-3903
Phone
(803) 642-5480
Fax
(803) 643-1800
NPI assigned
Aug 11, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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 4190 SC Primary

Addresses

Primary practice location

215 Barnwell Ave NW
Aiken, SC 29801-3903

Mailing address

215 Barnwell Ave NW
Aiken, SC 29801-3903
Phone (803) 642-5480

Other identifiers 1

IdentifierTypeStateIssuer
QM0382MedicaidSC

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
4190SCMDGeneral Practice Dentistry

NPI Registry JSON

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

{
    "created_epoch": "1155254400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1073524013",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "215 BARNWELL AVE NW",
            "city": "AIKEN",
            "state": "SC",
            "postal_code": "298013903",
            "telephone_number": "803-642-5480",
            "fax_number": "803-643-1800"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "215 BARNWELL AVE NW",
            "city": "AIKEN",
            "state": "SC",
            "postal_code": "298013903",
            "telephone_number": "803-642-5480",
            "fax_number": "803-643-1800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TREZZA",
        "first_name": "WILLIAM",
        "middle_name": "JOHN",
        "name_prefix": "Mr.",
        "credential": "LISW-CP",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-08-11",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "SC",
            "license": "4190",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "QM0382",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Aiken, SC

Sources for this page

Verify at the official NPI Registry.