Active NPI
Tresvant Llewellyn Clark
- Social Worker
- Columbia, SC
National Provider Identifier
1891634101
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Social Worker
- License
- 16627
- Practice address
- 220 Faison Dr
Columbia, SC 29203-3210 - Phone
- (803) 935-6742
- NPI assigned
- Mar 25, 2026
- Sex
- Male
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Social Worker | 104100000X | 16627 | SC | Primary |
Addresses
Primary practice location
220 Faison Dr
Columbia, SC 29203-3210
Mailing address
115 Deer Hound TRL
Columbia, SC 29223-2815
Phone (803) 935-6742
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 16627 | SC | MD | Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1774396800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1774396800000",
"number": "1891634101",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "115 DEER HOUND TRL",
"city": "COLUMBIA",
"state": "SC",
"postal_code": "292232815",
"telephone_number": "803-935-6742"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "220 FAISON DR",
"city": "COLUMBIA",
"state": "SC",
"postal_code": "292033210",
"telephone_number": "803-935-6742"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CLARK",
"first_name": "TRESVANT",
"middle_name": "LLEWELLYN",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2026-03-25",
"last_updated": "2026-03-25",
"certification_date": "2026-03-25",
"status": "A"
},
"taxonomies": [
{
"code": "104100000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Social Worker",
"state": "SC",
"license": "16627",
"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 Mar 25, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.