Active NPI
Lynn Ann Repasky, MSSW
- Clinical Social Worker
- Myrtle Beach, SC
National Provider Identifier
1114108446
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 21165
- Practice address
- 1101 Johnson Ave # 134D
Myrtle Beach, SC 29577-1893 - Phone
- (843) 232-2435
- NPI assigned
- Nov 15, 2007
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 0904009755 | VA | |
| Clinical Social Worker | 1041C0700X | 075327-1 | NY | |
| Clinical Social Worker | 1041C0700X | 21165 | CA | Primary |
Addresses
Primary practice location
1101 Johnson Ave # 134D
Myrtle Beach, SC 29577-1893
Mailing address
1101 Johnson Ave # 134D
Myrtle Beach, SC 29577-1893
Phone (843) 232-2435
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 075327-1 | NY | MD | Clinical Social Worker |
| 0904009755 | VA | MD | Clinical Social Worker |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Teladoc Health Medical Group, P.a. | Clinical | Current | Accepting new patients |
Interoperability endpoints
- lynnrepasky@tdh.allscriptsdirect.net
Organizations & group practices 1
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.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1195084800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1568592000000",
"number": "1114108446",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1101 JOHNSON AVE # 134D",
"city": "MYRTLE BEACH",
"state": "SC",
"postal_code": "295771893",
"telephone_number": "843-232-2435"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1101 JOHNSON AVE # 134D",
"city": "MYRTLE BEACH",
"state": "SC",
"postal_code": "295771893",
"telephone_number": "843-232-2435"
}
],
"practiceLocations": [],
"basic": {
"last_name": "REPASKY",
"first_name": "LYNN",
"middle_name": "ANN",
"credential": "MSSW",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-11-15",
"last_updated": "2019-09-16",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "VA",
"license": "0904009755",
"primary": false
},
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "NY",
"license": "075327-1",
"primary": false
},
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "CA",
"license": "21165",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Myrtle Beach, SC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 16, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.