Individual provider Active NPI

Suzanne Hartness Fentress, LISW-CP

  • Clinical Social Worker
  • Greer, SC
National Provider Identifier
1740462068
Registry record updated Jun 28, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
6853 Issued in SC
Practice address
955 W Wade Hampton Blvd Ste 4B
Greer, SC 29650
Phone
(864) 905-6835
Fax
(864) 334-5046
NPI assigned
Nov 28, 2007
Last updated
Jun 28, 2018By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 28, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 6853 SC Primary

Addresses

Primary practice location

955 W Wade Hampton Blvd Ste 4B
Greer, SC 29650

Mailing address

955 W Wade Hampton Blvd Ste 4B
Greer, SC 29650-1296
Phone (864) 905-6835

Other practice location 1

2125 McKenzie Rd
Pawhuska, OK 74056-9418
Phone (864) 905-6835

Other names 1

  • Suzanne Hartness Fentress Professional name

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
I20050816001086 SC Practitioner - Clinical Social Worker 1355371642 Practice locations: Greer, SC

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

66 Pkwy Commons Way
Greer, SC 29650-5213
Phone (864) 905-6835

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
CMS’s directory marks this NPI as on an HHS exclusion list; no matching OIG record was found. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.

State licenses

LicenseStateTypeSpecialty
6853SCMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Piedmont Psychiatric Service PA PastSince Jul 1, 1998 Accepting new patients
Anna Gagnon Therapy, LLC Clinical PastSince Apr 1, 2019 Accepting new patients

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1196208000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1530144000000",
    "number": "1740462068",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "955 W WADE HAMPTON BLVD STE 4B",
            "city": "GREER",
            "state": "SC",
            "postal_code": "296501296",
            "telephone_number": "864-905-6835",
            "fax_number": "864-334-5046"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "955 W WADE HAMPTON BLVD STE 4B",
            "city": "GREER",
            "state": "SC",
            "postal_code": "29650",
            "telephone_number": "864-905-6835",
            "fax_number": "864-334-5046"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2125 McKenzie Rd",
            "address_purpose": "LOCATION",
            "city": "Pawhuska",
            "state": "OK",
            "postal_code": "740569418",
            "country_code": "US",
            "telephone_number": "864-905-6835",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "FENTRESS",
        "first_name": "SUZANNE",
        "middle_name": "HARTNESS",
        "credential": "LISW-CP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-11-28",
        "last_updated": "2018-06-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "SC",
            "license": "6853",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SUZANNE",
            "last_name": "FENTRESS",
            "middle_name": "HARTNESS",
            "credential": "LISW-CP",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

Other providers in Greer, SC

Sources for this page

Verify at the official NPI Registry.