Rico Montineze Hogan, LCSW
Individual provider Active NPI Clinical Social Worker · Fort Eisenhower, GA
NPI 1871363481 · NPPES record last updated Jan 4, 2024
Key facts
- NPI
- 1871363481
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Clinical Social Worker 1041C0700X
- License
- C016133 (NC)
- Practice address
- Building 327, Central Hospital Rd.
Fort Eisenhower, GA 30905 - Phone
- (706) 787-8651
- NPI assigned
- Jan 4, 2024
- Sex
- Male
- Sole proprietor
- Yes
Organizations & group practices 1
Medicare Care Compare profile
- Specialty
- Clinical Social Worker
- Education
- Other, 2017
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Charleston Counseling Center PC
Practice addresses (Care Compare)
3600 Forest Dr
Suite 302
Columbia, SC 29204-4057
Phone (803) 699-8887
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in SC
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: No · Power mobility devices: No · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20260528002544 | SC | Practitioner - Clinical Social Worker | 1759851991 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| C016133 | NC | MD | Clinical Social Worker |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker |
1041C0700X | C016133 | NC | Yes |
Addresses
Primary practice location
Building 327, Central Hospital Rd.
Fort Eisenhower, GA 30905
Mailing address
2303 Mura Dr
Augusta, GA 30906-4819
Phone (706) 589-2883
Other providers in Fort Eisenhower, GA
- Joanna Lynn Harrod
- Jennifer Sue Hatfield
- Nicholas J Hendee
- Angie Hickey
- Chuan He Hicks
- Michelle Marie Holland
- Latrina Hollingsworth
- Erik Bruce Holm
- Tracy A.H. Horn
- Garrison Hughes
All providers in Fort Eisenhower, GA · Clinical Social Worker in Georgia
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 4, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.