Individual provider Active NPI

Tiffany Lynette Glisson, LCSW

  • Clinical Social Worker
  • Columbia, SC
National Provider Identifier
1235705989
Registry record updated Mar 4, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
15715 Issued in SC
Practice address
1703 Laurel St
Columbia, SC 29201-2660
Phone
(855) 743-2247
NPI assigned
Jun 2, 2021
Last updated
Mar 4, 2026By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 4, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X CSW006862 GA
Clinical Social Worker 1041C0700X 15715 SC Primary

Addresses

Primary practice location

1703 Laurel St
Columbia, SC 29201-2660

Mailing address

3436 Spring Creek Dr
Santa Rosa, CA 95405-7169
Phone (843) 224-2673

Other practice location 1

3436 Spring Creek Dr
Santa Rosa, CA 95405-7169
Phone (843) 224-2673

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
I20260422000880 SC Practitioner - Clinical Social Worker 0941777460 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2004
Medicare assignment
May accept Medicare assignment
Group practices
Eventus Wholehealth PLLCGroup PAC ID 6002169539, 301 clinicians

Practice addresses (Care Compare)

1703 Laurel St
Columbia, SC 29201-2660
Phone (855) 743-2247

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
CSW006862GAMDClinical Social Worker
15715SCMDClinical Social Worker

Organizations & group practices 2

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": "1622592000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1772582400000",
    "number": "1235705989",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3436 SPRING CREEK DR",
            "city": "SANTA ROSA",
            "state": "CA",
            "postal_code": "954057169",
            "telephone_number": "843-224-2673"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1703 LAUREL ST",
            "city": "COLUMBIA",
            "state": "SC",
            "postal_code": "292012660",
            "telephone_number": "855-743-2247"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3436 Spring Creek Dr",
            "address_purpose": "LOCATION",
            "city": "Santa Rosa",
            "state": "CA",
            "postal_code": "954057169",
            "country_code": "US",
            "telephone_number": "843-224-2673",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GLISSON",
        "first_name": "TIFFANY",
        "middle_name": "LYNETTE",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-06-02",
        "last_updated": "2026-03-04",
        "certification_date": "2026-03-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "GA",
            "license": "CSW006862",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "SC",
            "license": "15715",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Columbia, SC

Sources for this page

Verify at the official NPI Registry.