Individual provider Active NPI

Anna Grace Ridlehuber Corley, LMSW

  • Addiction (Substance Use Disorder) Counselor
  • Columbia, SC
National Provider Identifier
1902674872
Registry record updated Jan 6, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X
License
14393 Issued in SC
Practice address
2711 Colonial Dr
Columbia, SC 29203-6818
Phone
(803) 726-9300
NPI assigned
Dec 19, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 6, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X 17077 SC
Social Worker 104100000X
Addiction (Substance Use Disorder) Counselor 101YA0400X 14393 SC Primary

Addresses

Primary practice location

2711 Colonial Dr
Columbia, SC 29203-6818

Mailing address

2711 Colonial Dr
Columbia, SC 29203-6818

Other practice location 1

1801 Sunset Dr
Columbia, SC 29203-6803
Phone (803) 434-4153

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
14393SCMDAddiction (Substance Use Disorder) Counselor
17077SCMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Prisma Health Medical Group-Midlands CurrentSince Dec 4, 2024 Accepting new patients
Prisma Health Medical Group-Midlands CurrentSince Dec 4, 2024 Accepting new patients

Locations

2 Medical Park Rd
Ste 506
Columbia, SC 29203
Phone (803) 434-3930

1801 Sunset Dr
Columbia, SC 29203
Phone (803) 434-4153

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": "1702944000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1736121600000",
    "number": "1902674872",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2711 COLONIAL DR",
            "city": "COLUMBIA",
            "state": "SC",
            "postal_code": "292036818"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2711 COLONIAL DR",
            "city": "COLUMBIA",
            "state": "SC",
            "postal_code": "292036818",
            "telephone_number": "803-726-9300"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1801 Sunset Dr",
            "address_purpose": "LOCATION",
            "city": "Columbia",
            "state": "SC",
            "postal_code": "292036803",
            "country_code": "US",
            "telephone_number": "803-434-4153",
            "fax_number": "803-434-4160",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CORLEY",
        "first_name": "ANNA",
        "middle_name": "GRACE RIDLEHUBER",
        "credential": "LMSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-12-19",
        "last_updated": "2025-01-06",
        "certification_date": "2025-01-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "SC",
            "license": "17077",
            "primary": false
        },
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "SC",
            "license": "14393",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Columbia, SC

Sources for this page

Verify at the official NPI Registry.