Active NPI
Bailey Vickers
- Clinical Social Worker
- North Charleston, SC
National Provider Identifier
1790337053
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 14987
- Practice address
- 2811 Tricom St
North Charleston, SC 29406-9172 - Phone
- (843) 619-7989
- NPI assigned
- Jul 16, 2019
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Social Worker | 104100000X | 254173 | KY | |
| Clinical Social Worker | 1041C0700X | 14987 | SC | Primary |
Addresses
Primary practice location
2811 Tricom St
North Charleston, SC 29406-9172
Mailing address
2811 Tricom St
North Charleston, SC 29406-9172
Phone (843) 619-7989
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1790731081 | Medicaid | KY |
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
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Clinical Social Worker
- Education
- Other, 2019
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
4975 Lacross Rd
Suite 351
North Charleston, SC 29406-6530
Phone (800) 309-1159
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 254173 | KY | MD | Social Worker |
| 14987 | SC | MD | Clinical Social Worker |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Thrive Counseling LLC | Current | Accepting new patients |
Locations
4975 Lacross Rd
Ste 351
North Charleston, SC 29406
Phone (800) 309-1159
1000 Jefferson St
Ste 2C
Lynchburg, VA 24504
Phone (434) 528-3263
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": "1563235200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1652400000000",
"number": "1790337053",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2811 TRICOM ST",
"city": "NORTH CHARLESTON",
"state": "SC",
"postal_code": "294069172",
"telephone_number": "843-619-7989"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2811 TRICOM ST",
"city": "NORTH CHARLESTON",
"state": "SC",
"postal_code": "294069172",
"telephone_number": "843-619-7989"
}
],
"practiceLocations": [],
"basic": {
"last_name": "VICKERS",
"first_name": "BAILEY",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2019-07-16",
"last_updated": "2022-05-13",
"certification_date": "2022-05-13",
"status": "A"
},
"taxonomies": [
{
"code": "104100000X",
"taxonomy_group": "",
"desc": "Social Worker",
"state": "KY",
"license": "254173",
"primary": false
},
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "SC",
"license": "14987",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1790731081",
"state": "KY"
}
],
"endpoints": [],
"other_names": []
}
Other providers in North Charleston, SC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 13, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.