Jean Ellen Earhart, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

C006473 Issued in NC

Practice address

221 Grier St
Fort Mill, SC 29715-1630

Phone

(704) 804-4304

NPI assigned

May 1, 2007

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

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.

Opted out of Medicare

Yes, effective Jan 27, 2017 through Jan 27, 2027

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1177977600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1330387200000",
    "number": "1457572943",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "221 GRIER ST",
            "city": "FORT MILL",
            "state": "SC",
            "postal_code": "297151630",
            "telephone_number": "704-804-4304"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "221 GRIER ST",
            "city": "FORT MILL",
            "state": "SC",
            "postal_code": "297151630",
            "telephone_number": "704-804-4304"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EARHART",
        "first_name": "JEAN",
        "middle_name": "ELLEN",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-05-01",
        "last_updated": "2012-02-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NC",
            "license": "C006473",
            "primary": true
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "UT",
            "license": "4857335-3501",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "SC",
            "license": "9655",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Natalie Dunn, CCC-SLP
• Adam Richard Dutson, O.D.
• Hilary Ann Dwyer, LPC-A
• Gina Dyer-Goss, MSN-FN
• Dynamic Physical Therapy & Rehabilitation
• Logan B Ebersold, DMD
• Edge Solutions Group, LLC Dba Americare Fort Mill
• Trisha Edge, MBA
• Edgewater Medical Center
• Edgewater Urgent Care

• Clinical Social Worker in Fort Mill, SC
• Providers in Fort Mill, 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 Feb 28, 2012; 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; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.