Individual provider Active NPI

Sherie R Corbett

  • Social Worker
  • Summerville, SC
National Provider Identifier
1255477550
Registry record updated Oct 27, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
License
LISW-8883 Issued in SC
Practice address
106 Springview LN
Summerville, SC 29485-8108
Phone
(843) 873-5063
NPI assigned
Jan 30, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 27, 2015

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 8883 SC
Social Worker 104100000X LISW-8883 SC Primary

Addresses

Primary practice location

106 Springview LN
Summerville, SC 29485-8108

Mailing address

106 Springview LN
Summerville, SC 29485-8108

Other identifiers 2

IdentifierTypeStateIssuer
1760596480MedicaidSC
190166MedicaidSC

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
I20071011000358 SC Practitioner - Clinical Social Worker 2062508716 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Healing Roots Behavioral Health Center, LLCGroup PAC ID 3173803228, 2 clinicians

Practice addresses (Care Compare)

200 W 5TH N St
Suite C
Summerville, SC 29483-6512
Phone (843) 695-8865

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
LISW-8883SCMDSocial Worker
8883SCMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Healing Roots Behavioral Health Center, LLC Clinical CurrentSince Oct 24, 2016 Accepting new patients
South Carolina Dept of Mental Health Accounting Office Current Accepting new patients
South Carolina Dept of Mental Health Accounting Office CurrentSince Dec 30, 2014 Accepting new patients
South Carolina Dept of Mental Health Accounting Office CurrentSince Dec 30, 2014 Accepting new patients

Locations

2100 Charlie Hall Blvd
Charleston, SC 29414
Phone (843) 212-8968

2414 Bull St
#3183
Columbia, SC 29201

200 W 5th North St
#C
Summerville, SC 29483
Phone (843) 695-8865

Organizations & group practices 4

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": "1170115200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1445904000000",
    "number": "1255477550",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "106 SPRINGVIEW LN",
            "city": "SUMMERVILLE",
            "state": "SC",
            "postal_code": "294858108"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "106 SPRINGVIEW LN",
            "city": "SUMMERVILLE",
            "state": "SC",
            "postal_code": "294858108",
            "telephone_number": "843-873-5063"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CORBETT",
        "first_name": "SHERIE",
        "middle_name": "R",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-01-30",
        "last_updated": "2015-10-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "SC",
            "license": "8883",
            "primary": false
        },
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "SC",
            "license": "LISW-8883",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1760596480",
            "state": "SC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "190166",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Summerville, SC

Sources for this page

Verify at the official NPI Registry.