Kendra Marie Suddeth Miller, LISW-CP

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

13581 Issued in SC

Practice address

412 Saddlecrest CT
Blythewood, SC 29016-7631

Phone

(803) 587-8327

NPI assigned

Jun 17, 2022

Last updated

Nov 21, 2023By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

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

Specialty

Clinical Social Worker

Education

Other, 2004

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Charleston Counseling Center PCGroup PAC ID 6204125107, 186 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

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.

• Charleston Counseling Center PC

  dba Lifestance Health

  • Mental Health Counselor
  • Mount Pleasant, SC
  • NPI 1316375678

  Clinical

  Medicare reassignment Care Compare group NPD
• Myrtle Beach Counseling Center

  • Mental Health Counselor
  • Myrtle Beach, SC
  • NPI 1235784661
  NPD (past)

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

{
    "created_epoch": "1655424000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1700524800000",
    "number": "1265163687",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 72",
            "city": "BLYTHEWOOD",
            "state": "SC",
            "postal_code": "290160072",
            "telephone_number": "803-587-8327"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "412 SADDLECREST CT",
            "city": "BLYTHEWOOD",
            "state": "SC",
            "postal_code": "290167631",
            "telephone_number": "803-587-8327"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MILLER",
        "first_name": "KENDRA",
        "middle_name": "MARIE SUDDETH",
        "credential": "LISW-CP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-06-17",
        "last_updated": "2023-11-21",
        "certification_date": "2023-11-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041S0200X",
            "taxonomy_group": "",
            "desc": "Social Worker, School",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "SC",
            "license": "13581",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kelsey Klostermeyer McDill, M.D.
• Christa McLaughlin, MSW
• Mental Health America (Kiva)
• Mha
• Rutileia Da Silva Michel
• Wendy Monroe
• Andrew L. Moore, P.T.A.
• William Morrison, PT
• Mothering Me Maternity Services LLC
• Candy Lynnette Mullenix, RPH.

• Clinical Social Worker in Blythewood, SC
• Providers in Blythewood, SC by specialty
• Clinical Social Worker in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 21, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.