Individual provider Active NPI

Danielle June Baez, LISW-CP

  • Clinical Social Worker
  • Summerville, SC
National Provider Identifier
1366845430
Registry record updated Jan 26, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
13022 Issued in SC
Practice address
89 Old Trolley Rd Ste 202B
Summerville, SC 29485-4953
Phone
(854) 206-5513
Fax
(854) 246-8965
NPI assigned
Oct 3, 2014
Last updated
Jan 26, 2024By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 26, 2024

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 13022 SC Primary

Addresses

Primary practice location

89 Old Trolley Rd Ste 202B
Summerville, SC 29485-4953

Mailing address

89 Old Trolley Rd Ste 202B
Summerville, SC 29485-4953
Phone (854) 206-5513

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SC
Eligible to order & refer
  • Part B services: Yes
  • 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
I20211104000201 SC Practitioner - Clinical Social Worker 2264820612 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
University of Southern California Keck School of Medicine, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Carolina Grace CounselingGroup PAC ID 1052788890, 3 clinicians

Practice addresses (Care Compare)

89 Old Trolley Rd
Suite 202
Summerville, SC 29485-4951
Phone (854) 206-5513

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
13022SCMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Carolina Grace Counseling Clinical CurrentSince Apr 15, 2022 Accepting new patients

Locations

89 Old Trolley Rd
Ste 102
Summerville, SC 29485
Phone (843) 900-3590

89 Old Trolley Rd
Ste 102AB103
Summerville, SC 29485

89 Old Trolley Rd
Ste 202
Summerville, SC 29485
Phone (419) 699-2337

89 Old Trolley Rd
Ste 202
Summerville, SC 29485
Phone (854) 206-5513

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1412294400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1706227200000",
    "number": "1366845430",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "89 OLD TROLLEY RD STE 202B",
            "city": "SUMMERVILLE",
            "state": "SC",
            "postal_code": "294854953",
            "telephone_number": "854-206-5513",
            "fax_number": "854-423-3420"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "89 OLD TROLLEY RD STE 202B",
            "city": "SUMMERVILLE",
            "state": "SC",
            "postal_code": "294854953",
            "telephone_number": "854-206-5513",
            "fax_number": "854-246-8965"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BAEZ",
        "first_name": "DANIELLE",
        "middle_name": "JUNE",
        "credential": "LISW-CP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-10-03",
        "last_updated": "2024-01-26",
        "certification_date": "2024-01-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "SC",
            "license": "13022",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Summerville, SC

Sources for this page

Verify at the official NPI Registry.