Active NPI
Clyde Peter Morin, LISW-CP
- Clinical Social Worker
- Columbia, SC
National Provider Identifier
1861573412
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 1611
- Practice address
- 2015 Marion St,
Columbia, SC 29240-4440 - Phone
- (803) 898-0123
- Fax
- (803) 253-4090
- NPI assigned
- Oct 18, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 1611 | SC | Primary |
Addresses
Primary practice location
2015 Marion St,
Columbia, SC 29240-4440
Mailing address
2823 Blossom St
Columbia, SC 29205-2503
Phone (803) 799-9827
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
| License | State | Type | Specialty |
|---|---|---|---|
| 1611 | SC | MD | Ambulatory Women's Health Care Registered Nurse |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1161129600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1861573412",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2823 BLOSSOM ST",
"city": "COLUMBIA",
"state": "SC",
"postal_code": "292052503",
"telephone_number": "803-799-9827"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2015 MARION ST,",
"city": "COLUMBIA",
"state": "SC",
"postal_code": "292404440",
"telephone_number": "803-898-0123",
"fax_number": "803-253-4090"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MORIN",
"first_name": "CLYDE",
"middle_name": "PETER",
"name_prefix": "Mr.",
"credential": "LISW-CP",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-10-18",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "SC",
"license": "1611",
"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 Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.