Active NPI
Kayla Stevens, LISW-CP
- Clinical Social Worker
- Summerville, SC
National Provider Identifier
1639896293
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 15748
- Practice address
- 1544 State Rd
Summerville, SC 29486-2750 - Phone
- (843) 453-5303
- NPI assigned
- Oct 25, 2022
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 15748 | SC | Primary |
Addresses
Primary practice location
1544 State Rd
Summerville, SC 29486-2750
Mailing address
1544 State Rd
Summerville, SC 29486-2750
Phone (843) 453-5303
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Other URL | Foundationscwc.org |
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
| License | State | Type | Specialty |
|---|---|---|---|
| 15748 | SC | MD | Clinical Social Worker |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Foundations Counseling Behavioral Agency, LLC | Current | Accepting new patients |
Locations
111 Springhall Dr
#B
Goose Creek, SC 29445
Phone (843) 277-7216
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.
-
- Community/Behavioral Health Agency
- Goose Creek, SC
- NPI 1588491385
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1666656000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1720656000000",
"number": "1639896293",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1544 STATE RD",
"city": "SUMMERVILLE",
"state": "SC",
"postal_code": "294862750",
"telephone_number": "843-453-5303"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1544 STATE RD",
"city": "SUMMERVILLE",
"state": "SC",
"postal_code": "294862750",
"telephone_number": "843-453-5303"
}
],
"practiceLocations": [],
"basic": {
"last_name": "STEVENS",
"first_name": "KAYLA",
"credential": "LISW-CP",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2022-10-25",
"last_updated": "2024-07-11",
"certification_date": "2024-07-11",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "SC",
"license": "15748",
"primary": true
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "OTHERS",
"endpointTypeDescription": "Other URL",
"endpoint": "Foundationscwc.org",
"affiliation": "N",
"address_1": "111 Springhall Dr Unit B",
"city": "Goose Creek",
"state": "SC",
"country_code": "US",
"postal_code": "294455351",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}
Other providers in Summerville, SC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 11, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.