Individual provider Active NPI

Tirieka Scott Brown, M.S., S.SP

  • School Psychologist
  • Charleston, SC
National Provider Identifier
1508202698
Registry record updated Mar 17, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
School PsychologistTaxonomy code 103TS0200X
License
4674 Issued in SC
Practice address
1324 Secessionville Rd
Charleston, SC 29412-8231
Phone
(843) 225-5742
Fax
(843) 284-3909
NPI assigned
May 15, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 17, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
School Psychologist 103TS0200X 4674 SC Primary

Addresses

Primary practice location

1324 Secessionville Rd
Charleston, SC 29412-8231

Mailing address

1324 Secessionville Rd
Charleston, SC 29412-8231
Phone (843) 225-5742

Other practice location 1

75 Calhoun St
Charleston, SC 29401-3538
Phone (843) 852-6524

Other identifiers 1

IdentifierTypeStateIssuer
1588615918MedicaidSC

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
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
4674SCMDProfessional Counselor

NPI Registry JSON

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

{
    "created_epoch": "1368576000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1521244800000",
    "number": "1508202698",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1324 SECESSIONVILLE RD",
            "city": "CHARLESTON",
            "state": "SC",
            "postal_code": "294128231",
            "telephone_number": "843-225-5742",
            "fax_number": "843-284-3909"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1324 SECESSIONVILLE RD",
            "city": "CHARLESTON",
            "state": "SC",
            "postal_code": "294128231",
            "telephone_number": "843-225-5742",
            "fax_number": "843-284-3909"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "75 Calhoun St",
            "address_purpose": "LOCATION",
            "city": "Charleston",
            "state": "SC",
            "postal_code": "294013538",
            "country_code": "US",
            "telephone_number": "843-852-6524",
            "fax_number": "843-852-6532",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BROWN",
        "first_name": "TIRIEKA",
        "middle_name": "SCOTT",
        "name_prefix": "Ms.",
        "credential": "M.S., S.SP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-05-15",
        "last_updated": "2018-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TS0200X",
            "taxonomy_group": "",
            "desc": "Psychologist, School",
            "state": "SC",
            "license": "4674",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1588615918",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Charleston, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2018; 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.