Individual provider Active NPI

Charlie Anderson White, MSW, LISW-CP, BCD

  • Clinical Social Worker
  • Greenville, SC
National Provider Identifier
1073603494
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
00146 Issued in SC
Practice address
110 Manly St
Greenville, SC 29601-3025
Phone
(864) 298-8026
Fax
(864) 298-8032
NPI assigned
Oct 14, 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 00146 SC Primary

Addresses

Primary practice location

110 Manly St
Greenville, SC 29601-3025

Mailing address

110 Manly St
Greenville, SC 29601-3025
Phone (864) 298-8026

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
00146SCMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1160784000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1073603494",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "110 MANLY ST",
            "city": "GREENVILLE",
            "state": "SC",
            "postal_code": "296013025",
            "telephone_number": "864-298-8026",
            "fax_number": "864-298-8032"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "110 MANLY ST",
            "city": "GREENVILLE",
            "state": "SC",
            "postal_code": "296013025",
            "telephone_number": "864-298-8026",
            "fax_number": "864-298-8032"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WHITE",
        "first_name": "CHARLIE",
        "middle_name": "ANDERSON",
        "name_prefix": "Mr.",
        "credential": "MSW, LISW-CP, BCD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-10-14",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "SC",
            "license": "00146",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Greenville, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.