Jada Marie Reilley, LMSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

17425 Issued in SC

Practice address

61 Riverwalk Blvd Ste H
Ridgeland, SC 29936-3252

Phone

(843) 636-5017

Fax

(843) 202-0256

NPI assigned

Aug 14, 2023

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Bluffton Okatie Counseling Center, LLC

  • Clinical Social Worker
  • Ridgeland, SC
  • NPI 1225544562
  Medicare reassignment NPD
• South Carolina Online Counseling and Group Therapy, LLC

  • Professional Counselor
  • Ridgeland, SC
  • NPI 1154928448
  NPD

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

{
    "created_epoch": "1691971200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1730851200000",
    "number": "1083397293",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "61 RIVERWALK BLVD STE H",
            "city": "RIDGELAND",
            "state": "SC",
            "postal_code": "299363252",
            "telephone_number": "843-636-5017",
            "fax_number": "843-202-0256"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "61 RIVERWALK BLVD STE H",
            "city": "RIDGELAND",
            "state": "SC",
            "postal_code": "299363252",
            "telephone_number": "843-636-5017",
            "fax_number": "843-202-0256"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REILLEY",
        "first_name": "JADA",
        "middle_name": "MARIE",
        "credential": "LMSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-08-14",
        "last_updated": "2024-11-06",
        "certification_date": "2024-11-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "SC",
            "license": "17425",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Preferred Pharmacy LLC (Preferred Pharmacy)
• Pure E.a.G.L.E
• Starling Speed Ray III, DMD
• Recovery Concepts LLC
• Kristen Reeves
• Ridgeland Dialysis LLC (Ridgeland Dialysis)
• Ridgeland Drug Company Inc (Coastal Apothecary)
• Ridgeland Eye Associates LLC
• Ridgeland NC LLC (Ridgeland NC)
• Ridgeland Nursing Center Inc

• Clinical Social Worker in Ridgeland, SC
• Providers in Ridgeland, SC by specialty
• Clinical Social Worker in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 6, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.