Individual provider Active NPI

Darrell William Jones, LCSW, BCD

  • Clinical Social Worker
  • Graniteville, SC
National Provider Identifier
1205994886
Registry record updated Dec 6, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
12806 Issued in SC
Practice address
3524 Jefferson Davis Highway
Graniteville, SC 29829
Phone
(912) 508-2582
NPI assigned
Dec 5, 2006
Last updated
Dec 6, 2024By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 6, 2024

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 12806 SC Primary

Addresses

Primary practice location

3524 Jefferson Davis Highway
Graniteville, SC 29829

Mailing address

139 Barnard Ave SE
Aiken, SC 29801-7203
Phone (912) 508-2582

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20200206001136 SC Practitioner - Clinical Social Worker 7214197250 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
12806SCMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Season 4 Change, LLC CurrentSince Dec 6, 2019 Accepting new patients

Locations

3524 Jefferson Davis Highw
Graniteville, SC 29829
Phone (803) 232-7530

3524 Jefferson Davis Hwy
Graniteville, SC 29829
Phone (803) 232-7530

3524 Jefferson Davis Hwy
Graniteville, SC 29829
Phone (803) 380-9004

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1165276800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1733443200000",
    "number": "1205994886",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "139 BARNARD AVE SE",
            "city": "AIKEN",
            "state": "SC",
            "postal_code": "298017203",
            "telephone_number": "912-508-2582"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3524 JEFFERSON DAVIS HIGHWAY",
            "city": "GRANITEVILLE",
            "state": "SC",
            "postal_code": "29829",
            "telephone_number": "912-508-2582"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JONES",
        "first_name": "DARRELL",
        "middle_name": "WILLIAM",
        "credential": "LCSW, BCD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-12-05",
        "last_updated": "2024-12-06",
        "certification_date": "2024-12-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "SC",
            "license": "12806",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Graniteville, SC

Sources for this page

Verify at the official NPI Registry.