Individual provider Active NPI

Marvin M Bryant, MSW, LISW-CP

  • Clinical Social Worker
  • Columbia, SC
National Provider Identifier
1225124175
Registry record updated Nov 28, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
4418 Issued in SC
Practice address
1113 Belleview St Ste 101
Columbia, SC 29201-1839
Phone
(803) 764-5377
Fax
(803) 764-4028
NPI assigned
Oct 5, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 28, 2022

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 4418 SC Primary

Addresses

Primary practice location

1113 Belleview St Ste 101
Columbia, SC 29201-1839

Mailing address

1006 Kenmore Dr
Columbia, SC 29209-2124
Phone (803) 776-7708

Other practice location 1

125 Alpine Cir
Columbia, SC 29223-6385
Phone (037) 793-5488

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
I20110728000102 SC Practitioner - Clinical Social Worker 2163690637 Practice locations: Columbia, SC

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1990
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

1113 Belleview St
Suite 101
Columbia, SC 29201-1839
Phone (803) 764-5377

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
4418SCMDOccupational Therapist

NPI Registry JSON

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

{
    "created_epoch": "1160006400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1669593600000",
    "number": "1225124175",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1006 KENMORE DR",
            "city": "COLUMBIA",
            "state": "SC",
            "postal_code": "292092124",
            "telephone_number": "803-776-7708",
            "fax_number": "803-776-0338"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1113 BELLEVIEW ST STE 101",
            "city": "COLUMBIA",
            "state": "SC",
            "postal_code": "292011839",
            "telephone_number": "803-764-5377",
            "fax_number": "803-764-4028"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "125 Alpine Cir",
            "address_purpose": "LOCATION",
            "city": "Columbia",
            "state": "SC",
            "postal_code": "292236385",
            "country_code": "US",
            "telephone_number": "037-793-5488",
            "fax_number": "803-779-7055",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BRYANT",
        "first_name": "MARVIN",
        "middle_name": "M",
        "name_prefix": "Mr.",
        "credential": "MSW, LISW-CP",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-10-05",
        "last_updated": "2022-11-28",
        "certification_date": "2021-11-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "SC",
            "license": "4418",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Columbia, SC

Sources for this page

Verify at the official NPI Registry.