Individual provider Active NPI

Marie Leann Gardner

  • Clinical Social Worker
  • North Charleston, SC
National Provider Identifier
1336597426
Registry record updated Nov 8, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
8626 Issued in SC
Practice address
5107 N Rhett Ave
North Charleston, SC 29405-4219
Phone
(803) 447-2003
NPI assigned
May 30, 2016
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 8, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 8626 SC Primary

Addresses

Primary practice location

5107 N Rhett Ave
North Charleston, SC 29405-4219

Mailing address

5107 N Rhett Ave
North Charleston, SC 29405-4219
Phone (803) 447-2003

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
8626SCMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1464566400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1699401600000",
    "number": "1336597426",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5107 N RHETT AVE",
            "city": "NORTH CHARLESTON",
            "state": "SC",
            "postal_code": "294054219",
            "telephone_number": "803-447-2003"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5107 N RHETT AVE",
            "city": "NORTH CHARLESTON",
            "state": "SC",
            "postal_code": "294054219",
            "telephone_number": "803-447-2003"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GARDNER",
        "first_name": "MARIE",
        "middle_name": "LEANN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-05-30",
        "last_updated": "2023-11-08",
        "certification_date": "2023-11-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "SC",
            "license": "8626",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in North Charleston, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 8, 2023; 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.