Individual provider Active NPI

Breanna Williams, LMSW

  • Social Worker
  • Charleston, SC
National Provider Identifier
1265093884
Registry record updated Mar 1, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
License
105779-1 Issued in NY
Practice address
2100 Charlie Hall Blvd
Charleston, SC 29414-5832
Phone
(843) 852-4100
NPI assigned
Jun 25, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 1, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X 105779-1 NY Primary

Addresses

Primary practice location

2100 Charlie Hall Blvd
Charleston, SC 29414-5832

Mailing address

2100 Charlie Hall Blvd
Charleston, SC 29414-5832
Phone (843) 852-4100

Other practice location 1

3300 Dewey Ave
Rochester, NY 14616-3741
Phone (585) 865-1550 ext. 433

Other identifiers 1

IdentifierTypeStateIssuer
1760596480MedicaidSC

Other names 1

  • Breanna Steward Former name

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
105779-1NYMDSocial Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Villa of Hope PastSince May 10, 2016 Accepting new patients

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": "1561420800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1614556800000",
    "number": "1265093884",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2100 CHARLIE HALL BLVD",
            "city": "CHARLESTON",
            "state": "SC",
            "postal_code": "294145832",
            "telephone_number": "843-852-4100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2100 CHARLIE HALL BLVD",
            "city": "CHARLESTON",
            "state": "SC",
            "postal_code": "294145832",
            "telephone_number": "843-852-4100"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3300 Dewey Ave",
            "address_purpose": "LOCATION",
            "city": "Rochester",
            "state": "NY",
            "postal_code": "146163741",
            "country_code": "US",
            "telephone_number": "585-865-1550 x433",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WILLIAMS",
        "first_name": "BREANNA",
        "credential": "LMSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-06-25",
        "last_updated": "2021-03-01",
        "certification_date": "2021-03-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "NY",
            "license": "105779-1",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1760596480",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "BREANNA",
            "last_name": "STEWARD",
            "credential": "LMSW",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Charleston, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 1, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.