Individual provider Active NPI

Brooke E Berger, LISW-CP, ADC

  • Clinical Social Worker
  • West Columbia, SC
National Provider Identifier
1639467319
Registry record updated Jan 17, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
9545 Issued in SC
Practice address
3975 Southeastern Way
West Columbia, SC 29169-2442
Phone
(803) 262-0862
NPI assigned
Jul 15, 2011
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 17, 2024

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 SC
Clinical Social Worker 1041C0700X 9545 SC Primary

Addresses

Primary practice location

3975 Southeastern Way
West Columbia, SC 29169-2442

Mailing address

3975 Southeastern Way
West Columbia, SC 29169-2442
Phone (803) 262-0862

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Opted out of Medicare
Yes, effective Jul 1, 2024 through Jul 1, 2028

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
9545SCMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Lexington Richland Alcohol & Drug Abuse Council, Inc. PastSince Nov 26, 2023 Accepting new patients

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1310688000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1705449600000",
    "number": "1639467319",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3975 SOUTHEASTERN WAY",
            "city": "WEST COLUMBIA",
            "state": "SC",
            "postal_code": "291692442",
            "telephone_number": "803-262-0862"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3975 SOUTHEASTERN WAY",
            "city": "WEST COLUMBIA",
            "state": "SC",
            "postal_code": "291692442",
            "telephone_number": "803-262-0862"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BERGER",
        "first_name": "BROOKE",
        "middle_name": "E",
        "credential": "LISW-CP, ADC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-07-15",
        "last_updated": "2024-01-17",
        "certification_date": "2024-01-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "SC",
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "SC",
            "license": "9545",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in West Columbia, SC

Sources for this page

Verify at the official NPI Registry.