Individual provider Active NPI

Amber Whitaker Tolbert, LCSW, LISW-CP

  • Clinical Social Worker
  • Fort Mill, SC
National Provider Identifier
1356689301
Registry record updated Jul 9, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
C008417 Issued in NC
Practice address
975 Market St
Suite 211
Fort Mill, SC 29708-6530
Phone
(864) 276-1788
NPI assigned
Jan 25, 2013
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 9, 2014

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 10695 SC
Clinical Social Worker 1041C0700X C008417 NC Primary

Addresses

Primary practice location

975 Market St
Suite 211
Fort Mill, SC 29708-6530

Mailing address

975 Market St
Suite 211
Fort Mill, SC 29708-6530
Phone (864) 276-1788

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
C008417NCMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1359072000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1404864000000",
    "number": "1356689301",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "975 MARKET ST",
            "address_2": "SUITE 211",
            "city": "FORT MILL",
            "state": "SC",
            "postal_code": "297086530",
            "telephone_number": "864-276-1788"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "975 MARKET ST",
            "address_2": "SUITE 211",
            "city": "FORT MILL",
            "state": "SC",
            "postal_code": "297086530",
            "telephone_number": "864-276-1788"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TOLBERT",
        "first_name": "AMBER",
        "middle_name": "WHITAKER",
        "name_prefix": "Mrs.",
        "credential": "LCSW, LISW-CP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-01-25",
        "last_updated": "2014-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "SC",
            "license": "10695",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NC",
            "license": "C008417",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Mill, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2014; 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.