Individual provider Active NPI

Kate Nelligan, LISW

  • Clinical Social Worker
  • Newberry, SC
National Provider Identifier
1366625543
Registry record updated Dec 11, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
6689 Issued in SC
Practice address
800 Main St
Newberry, SC 29108-3351
Phone
(803) 276-5690
Fax
(803) 321-2234
NPI assigned
Dec 11, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 11, 2007

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 6689 SC Primary

Addresses

Primary practice location

800 Main St
Newberry, SC 29108-3351

Mailing address

PO Box 738
Newberry, SC 29108-0738
Phone (803) 276-5690

Other identifiers 1

IdentifierTypeStateIssuer
AD35NEMedicaidSC

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SC
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160627001978 SC Practitioner - Clinical Social Worker 7911202858

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
6689NCMDHealth Service Psychologist
6689SCMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1197331200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1197331200000",
    "number": "1366625543",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 738",
            "city": "NEWBERRY",
            "state": "SC",
            "postal_code": "291080738",
            "telephone_number": "803-276-5690",
            "fax_number": "803-321-2234"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "800 MAIN ST",
            "city": "NEWBERRY",
            "state": "SC",
            "postal_code": "291083351",
            "telephone_number": "803-276-5690",
            "fax_number": "803-321-2234"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NELLIGAN",
        "first_name": "KATE",
        "name_prefix": "Ms.",
        "credential": "LISW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-12-11",
        "last_updated": "2007-12-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "SC",
            "license": "6689",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "AD35NE",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Newberry, SC

Sources for this page

Verify at the official NPI Registry.