Individual provider Active NPI

Dzyre Monejah Wilks

  • Social Worker
  • Myrtle Beach, SC
National Provider Identifier
1699401513
Registry record updated Jul 25, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
License
15258 Issued in SC
Practice address
6215 Highway 707
Myrtle Beach, SC 29588-7362
Phone
(843) 273-0077
NPI assigned
Jul 25, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 25, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X 15258 SC Primary

Addresses

Primary practice location

6215 Highway 707
Myrtle Beach, SC 29588-7362

Mailing address

4470 Little River Inn LN Apt 1007
Little River, SC 29566-6090
Phone (845) 701-6970

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SC
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20260520000496 SC Practitioner - Clinical Social Worker 9830668755 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2022
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

PO Box
Suite 31447
Myrtle Beach, SC 29588

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
15258SCMDSocial Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Real Counseling, LLC CurrentSince Jul 31, 2022 Accepting new patients

Locations

1124 Sea Mountain Hwy
Unit 5
North Myrtle Beach, SC 29582
Phone (843) 273-0077

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": "1658707200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658707200000",
    "number": "1699401513",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4470 LITTLE RIVER INN LN APT 1007",
            "city": "LITTLE RIVER",
            "state": "SC",
            "postal_code": "295666090",
            "telephone_number": "845-701-6970"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6215 HIGHWAY 707",
            "city": "MYRTLE BEACH",
            "state": "SC",
            "postal_code": "295887362",
            "telephone_number": "843-273-0077"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILKS",
        "first_name": "DZYRE",
        "middle_name": "MONEJAH",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-07-25",
        "last_updated": "2022-07-25",
        "certification_date": "2022-07-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "SC",
            "license": "15258",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Myrtle Beach, SC

Sources for this page

Verify at the official NPI Registry.