Individual provider Active NPI

Robert Paul Luciano Jr.

  • Clinical Social Worker
  • Myrtle Beach, SC
National Provider Identifier
1649795626
Registry record updated Mar 21, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
Practice address
1551 21St Ave N Ste 2
Myrtle Beach, SC 29577-7495
Phone
(843) 655-6089
NPI assigned
Aug 10, 2017
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 21, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social WorkerGroup: 193400000X SINGLE SPECIALTY GROUP 1041C0700X Primary

Addresses

Primary practice location

1551 21St Ave N Ste 2
Myrtle Beach, SC 29577-7495

Mailing address

1551 21St Ave N Ste 2
Myrtle Beach, SC 29577-7495
Phone (843) 655-6089

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

NPI Registry JSON

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

{
    "created_epoch": "1502323200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1710979200000",
    "number": "1649795626",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1551 21ST AVE N STE 2",
            "city": "MYRTLE BEACH",
            "state": "SC",
            "postal_code": "295777495",
            "telephone_number": "843-655-6089"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1551 21ST AVE N STE 2",
            "city": "MYRTLE BEACH",
            "state": "SC",
            "postal_code": "295777495",
            "telephone_number": "843-655-6089"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LUCIANO",
        "first_name": "ROBERT",
        "middle_name": "PAUL",
        "name_suffix": "Jr.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2017-08-10",
        "last_updated": "2024-03-21",
        "certification_date": "2024-03-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Myrtle Beach, SC

Sources for this page

Verify at the official NPI Registry.