Individual provider Active NPI

Celita Brooke Proffitt Hastie, LISW

  • Clinical Social Worker
  • Columbia, SC
National Provider Identifier
1770642316
Registry record updated Oct 13, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
8488 Issued in SC
Practice address
4626 Clemson Ave
Columbia, SC 29206-4401
Phone
(803) 556-7991
NPI assigned
Dec 8, 2006
Last updated
Oct 13, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 13, 2023

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 8488 SC Primary

Addresses

Primary practice location

4626 Clemson Ave
Columbia, SC 29206-4401

Mailing address

4626 Clemson Ave
Columbia, SC 29206-4401
Phone (803) 556-7991

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
8488SCMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Counseling & Consultant Services LLC Clinical Past 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, 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": "1165536000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1697155200000",
    "number": "1770642316",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4626 CLEMSON AVE",
            "city": "COLUMBIA",
            "state": "SC",
            "postal_code": "292064401",
            "telephone_number": "803-556-7991"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4626 CLEMSON AVE",
            "city": "COLUMBIA",
            "state": "SC",
            "postal_code": "292064401",
            "telephone_number": "803-556-7991"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HASTIE",
        "first_name": "CELITA",
        "middle_name": "BROOKE PROFFITT",
        "credential": "LISW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-12-08",
        "last_updated": "2023-10-13",
        "certification_date": "2023-10-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "SC",
            "license": "8488",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Columbia, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 13, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.