Tina Celeste Outlaw, BSW,MSW, LISW-CP

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

5160 Issued in SC

Practice address

2919 Jeffords Rd N
Outlaw's Vision Quest Farm, Inc.
Lamar, SC 29069-9494

Phone

(843) 857-0298

NPI assigned

Dec 22, 2006

Last updated

Jan 18, 2023By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

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.

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Interoperability endpoints

• Direct secure messaging: tinaoutlaw@tdh.allscriptsdirect.net

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.

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  NPD (past)

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

{
    "created_epoch": "1166745600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1674000000000",
    "number": "1407911332",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2919 JEFFORDS RD",
            "city": "LAMAR",
            "state": "SC",
            "postal_code": "290699494",
            "telephone_number": "843-713-6205"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2919 JEFFORDS RD N",
            "address_2": "OUTLAW'S VISION QUEST FARM, INC.",
            "city": "LAMAR",
            "state": "SC",
            "postal_code": "290699494",
            "telephone_number": "843-857-0298"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OUTLAW",
        "first_name": "TINA",
        "middle_name": "CELESTE",
        "name_prefix": "Ms.",
        "credential": "BSW,MSW, LISW-CP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-12-22",
        "last_updated": "2023-01-18",
        "certification_date": "2023-01-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "SC",
            "license": "5160",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "SW1208",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Elizabeth Sturgeon Hubbard, RN
• Brianna Jacobs
• Cynthia K Katko, MCD, CCC-SLP
• Gretchen Anne McCathern, RPT
• Joshua Dennis Murphy, FNP
• Catherine Cummings Parnell, RN
• Piggly Wiggly of Lamar LLC (Piggly Wiggly Pharmacy #196)
• Piggly Wiggly Retail Stores, Inc. (Piggly Wiggly Pharmacy #112)
• Kendall Shelby Rivers
• Jim Sandlin, RPH

• Clinical Social Worker in Lamar, SC
• Providers in Lamar, SC by specialty
• Clinical Social Worker in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 18, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.