Carol Ann Fletcher, MSW

Key facts

NPI

1295952232

Entity type

Individual (NPI type 1)

Primary specialty

Clinical Social Worker 1041C0700X

License

11660 (SC)

Practice address

901 N. Kings Highway
Myrtle Beach, SC 29577

Phone

(843) 448-4820

Fax

(843) 448-9875

NPI assigned

Apr 19, 2007

Sex

Female

Sole proprietor

No

Organizations & group practices 7

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.

• Charleston Counseling Center PC Mental Health Counselor · Mount Pleasant, SC · NPI 1316375678
  Medicare reassignment NPD CLINICAL · SC
• Coastal Haven Counseling LLC Mental Health Counselor · Myrtle Beach, SC · NPI 1609314293
  Medicare reassignment NPD SC
• Coastal Samaritan Counseling Center Community/Behavioral Health Agency · Myrtle Beach, SC · NPI 1922189679
  Medicare reassignment NPD SC
• Real Counseling, LLC Professional Counselor · Myrtle Beach, SC · NPI 1518262138
  Medicare reassignment NPD SC
• Grow Healthcare Group PA Mental Health Counselor · Miami, FL · NPI 1245845932
  Medicare reassignment NPD CLINICAL · DC · FL · IL · MA · NC · PA · RI · SC · TX
• Myrtle Beach Counseling Center Mental Health Counselor · Myrtle Beach, SC · NPI 1235784661
  NPD
• Southside Behavioral Health Community/Behavioral Health Agency · Clarksville, VA · NPI 1700890761
  NPD (past) CLINICAL

Medicare Care Compare profile

Specialty

Clinical Social Worker

Education

Other, 2012

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare participation

Medicare fee-for-service enrollment

Enrolled (9 enrollments) in SC, IL, PA, TX, NC, MA, DC, FL, RI

Eligible to order & refer

Part B services: Yes · DME: Yes · Home health: No · Power mobility devices: No · Hospice: No

Medicare enrollment records

National Provider Directory

Medicare enrollment (NPD)

Yes

State licenses

Practice roles

Locations

Specialties & licenses

Addresses

Other identifiers

Other names

• Carol Ann Lavancher Former name

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Jul 21, 2022.

{
    "created_epoch": "1176940800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1295952232",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "P.O. BOX 2967",
            "address_2": "901 N KINGS HIGHWAY",
            "city": "MYRTLE BEACH",
            "state": "SC",
            "postal_code": "29577",
            "telephone_number": "843-448-4820",
            "fax_number": "843-488-9875"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "901 N. KINGS HIGHWAY",
            "city": "MYRTLE BEACH",
            "state": "SC",
            "postal_code": "29577",
            "telephone_number": "843-448-4820",
            "fax_number": "843-448-9875"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FLETCHER",
        "first_name": "CAROL",
        "middle_name": "ANN",
        "credential": "MSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-04-19",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "NC",
            "license": "C010142",
            "primary": false
        },
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "VA",
            "license": "0904007878",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "073234-1",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "PA",
            "license": "CW015716",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "VA",
            "license": "0904007878",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "SC",
            "license": "11660",
            "primary": true
        },
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "PA",
            "license": "5933",
            "primary": false
        },
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "VA",
            "license": "03000212CR",
            "primary": false
        },
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "VA",
            "license": "03098012AR",
            "primary": false
        },
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "SC",
            "license": "1612211",
            "primary": false
        },
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "SC",
            "license": "11660",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "SW1366",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "CAROL",
            "last_name": "LAVANCHER",
            "middle_name": "ANN",
            "credential": "MSW",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

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