Active NPI
Tracey Phillips, PHD, LMSW
- Social Worker
- North Charleston, SC
National Provider Identifier
1073863742
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Social Worker
- License
- 8209
- Practice address
- 4390 Belle Oaks Dr
North Charleston, SC 29405-8559 - Phone
- (843) 554-7244
- NPI assigned
- Sep 11, 2012
- Last updated
- Jan 22, 2015
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Social Worker | 104100000X | 8209 | SC | Primary |
Addresses
Primary practice location
4390 Belle Oaks Dr
North Charleston, SC 29405-8559
Mailing address
4390 Belle Oaks Dr
North Charleston, SC 29405-8559
Phone (843) 554-7244
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
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 8209 | SC | MD | Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1347321600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1421884800000",
"number": "1073863742",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4390 BELLE OAKS DR",
"city": "NORTH CHARLESTON",
"state": "SC",
"postal_code": "294058559",
"telephone_number": "843-554-7244"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4390 BELLE OAKS DR",
"city": "NORTH CHARLESTON",
"state": "SC",
"postal_code": "294058559",
"telephone_number": "843-554-7244"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PHILLIPS",
"first_name": "TRACEY",
"name_prefix": "Dr.",
"credential": "PHD, LMSW",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2012-09-11",
"last_updated": "2015-01-22",
"status": "A"
},
"taxonomies": [
{
"code": "104100000X",
"taxonomy_group": "",
"desc": "Social Worker",
"state": "SC",
"license": "8209",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in North Charleston, SC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 22, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.