Individual provider Active NPI

Susan G McEachern, LCSW,LMSW

  • Clinical Social Worker
  • Dillon, SC
National Provider Identifier
1457890170
Registry record updated Feb 14, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
001692 Issued in NC
Practice address
510 Rosewood Dr
Dillon, SC 29536-7423
Phone
(910) 628-9091
Fax
(910) 628-9092
NPI assigned
Feb 14, 2017
Last updated
Feb 14, 2017By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 14, 2017

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 001692 NC Primary
Clinical Social Worker 1041C0700X 1222 SC

Addresses

Primary practice location

510 Rosewood Dr
Dillon, SC 29536-7423

Mailing address

510 Rosewood Dr
Dillon, SC 29536-7423
Phone (910) 628-9091

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
1222SCMDCounselor
001692NCMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1487030400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1487030400000",
    "number": "1457890170",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "510 ROSEWOOD DR",
            "city": "DILLON",
            "state": "SC",
            "postal_code": "295367423",
            "telephone_number": "910-628-9091",
            "fax_number": "910-628-9092"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "510 ROSEWOOD DR",
            "city": "DILLON",
            "state": "SC",
            "postal_code": "295367423",
            "telephone_number": "910-628-9091",
            "fax_number": "910-628-9092"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCEACHERN",
        "first_name": "SUSAN",
        "middle_name": "G",
        "credential": "LCSW,LMSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-02-14",
        "last_updated": "2017-02-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NC",
            "license": "001692",
            "primary": true
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "SC",
            "license": "1222",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dillon, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 14, 2017; 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.