NPIMap

Organization Active NPI

Healing Roots Behavioral Health Center, LLC

  • Clinical Social Worker
  • Summerville, SC
National Provider Identifier
1336697499
Registry record updated Dec 27, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
8883 Issued in SC
Legal business name
HEALING ROOTS BEHAVIORAL HEALTH CENTER, LLC
Practice address
200 W. 5TH North Street, Suite C
Healing Roots Behavioral Health Center, LLC
Summerville, SC 29483-6618
Phone
(843) 695-8865
Fax
(843) 695-8517
NPI assigned
Sep 19, 2016
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 27, 2017

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

Authorized official

Name
Mrs. Sherie R. Corbett, MSW ,LISW-CPNPI 1255477550
Title
Therapist/Owner
Phone
(843) 695-8865

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social WorkerGroup: 193200000X MULTI-SPECIALTY GROUP 1041C0700X 8883 SC Primary

Addresses

Primary practice location

200 W. 5TH North Street, Suite C
Healing Roots Behavioral Health Center, LLC
Summerville, SC 29483-6618

Mailing address

200 W. 5TH North Street, Suite C
Healing Roots Behavioral Health Center, LLC
Summerville, SC 29483-6618
Phone (843) 695-8865

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SC

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20161206001779 SC Part B Supplier - Clinic/Group Practice 3173803228 Receives reassigned benefits from 2 practitioners
Practice locations: Summerville, SC

National Provider Directory

National Provider Directory

Locations

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

Practitioners & affiliated clinicians

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1474243200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1514332800000",
    "number": "1336697499",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 W. 5TH NORTH STREET, SUITE C",
            "address_2": "HEALING ROOTS BEHAVIORAL HEALTH CENTER, LLC",
            "city": "SUMMERVILLE",
            "state": "SC",
            "postal_code": "294836618",
            "telephone_number": "843-695-8865",
            "fax_number": "843-695-8517"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 W. 5TH NORTH STREET, SUITE C",
            "address_2": "HEALING ROOTS BEHAVIORAL HEALTH CENTER, LLC",
            "city": "SUMMERVILLE",
            "state": "SC",
            "postal_code": "294836618",
            "telephone_number": "843-695-8865",
            "fax_number": "843-695-8517"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HEALING ROOTS BEHAVIORAL HEALTH CENTER, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-09-19",
        "last_updated": "2017-12-27",
        "status": "A",
        "authorized_official_last_name": "CORBETT",
        "authorized_official_first_name": "SHERIE",
        "authorized_official_middle_name": "R.",
        "authorized_official_title_or_position": "THERAPIST/OWNER",
        "authorized_official_telephone_number": "843-695-8865",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "MSW ,LISW-CP"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Social Worker, Clinical",
            "state": "SC",
            "license": "8883",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Summerville, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 27, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.