Individual provider Active NPI

Sarah Jean Wise, LISW-CP

  • Clinical Social Worker
  • Charleston, SC
National Provider Identifier
1841664125
Registry record updated Mar 9, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
9553 Issued in SC
Practice address
4 Carriage LN Ste 308
Charleston, SC 29407-6050
Phone
(800) 552-4357
Fax
(678) 388-9244
NPI assigned
Nov 24, 2015
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 9, 2021

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 9553 SC Primary

Addresses

Primary practice location

4 Carriage LN Ste 308
Charleston, SC 29407-6050

Mailing address

1710 Trolley Rd Ste E
Summerville, SC 29485-8281
Phone (180) 055-2435

Other practice location 1

402 S Live Oak Dr
Moncks Corner, SC 29461-3445
Phone (843) 879-4121

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

Practice roles

OrganizationSpecialtyStatusNew patients
Myrtle Beach Counseling Center CurrentSince Nov 1, 2021 Accepting new patients
Covenant Counseling of South Carolina PastSince Jun 12, 2009 Accepting new patients

Locations

871 Lowcountry Blvd
Ste 200
Mt Pleasant, SC 29464
Phone (253) 346-0137

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1448323200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1615248000000",
    "number": "1841664125",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1710 TROLLEY RD STE E",
            "city": "SUMMERVILLE",
            "state": "SC",
            "postal_code": "294858281",
            "telephone_number": "180-055-2435",
            "fax_number": "678-388-9244"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4 CARRIAGE LN STE 308",
            "city": "CHARLESTON",
            "state": "SC",
            "postal_code": "294076050",
            "telephone_number": "800-552-4357",
            "fax_number": "678-388-9244"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "402 S Live Oak Dr",
            "address_purpose": "LOCATION",
            "city": "Moncks Corner",
            "state": "SC",
            "postal_code": "294613445",
            "country_code": "US",
            "telephone_number": "843-879-4121",
            "fax_number": "866-556-9303",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WISE",
        "first_name": "SARAH",
        "middle_name": "JEAN",
        "credential": "LISW-CP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-11-24",
        "last_updated": "2021-03-09",
        "certification_date": "2021-03-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "SC",
            "license": "9553",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Charleston, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 9, 2021; 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.