Individual provider Active NPI

Penni Ann Sutton, MSW, LISW

  • Clinical Social Worker
  • Atlanta, GA
National Provider Identifier
1912064379
Registry record updated Mar 31, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
7101 Issued in SC
Practice address
1050 Crown Pointe Pkwy
Suite 450
Atlanta, GA 30338-7707
Phone
(866) 325-5434
NPI assigned
Jan 3, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 31, 2011

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 7101 SC Primary

Addresses

Primary practice location

1050 Crown Pointe Pkwy
Suite 450
Atlanta, GA 30338-7707

Mailing address

806 12TH St
Port Royal, SC 29935-2131

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SC
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110511000104 SC Practitioner - Clinical Social Worker 9537345475 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Carolina Psychiatric Services IncGroup PAC ID 5991792046, 6 clinicians

Practice addresses (Care Compare)

160 Medical Cir
West Columbia, SC 29169-3639
Phone 803796681111

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
7101SCMDPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist

Practice roles

OrganizationSpecialtyStatusNew patients
Carolina Psychiatric Services, Inc Clinical CurrentSince Oct 10, 2019 Accepting new patients
Senior Psych Solutions Corp Clinical Past Accepting new patients

Locations

160 Medical Cir
Fl 1
West Columbia, SC 29169
Phone (803) 796-6811

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": "1167782400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1301529600000",
    "number": "1912064379",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "806 12TH ST",
            "city": "PORT ROYAL",
            "state": "SC",
            "postal_code": "299352131"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1050 CROWN POINTE PKWY",
            "address_2": "SUITE 450",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303387707",
            "telephone_number": "866-325-5434"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SUTTON",
        "first_name": "PENNI",
        "middle_name": "ANN",
        "name_prefix": "Ms.",
        "credential": "MSW, LISW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-01-03",
        "last_updated": "2011-03-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "SC",
            "license": "7101",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Atlanta, GA

Sources for this page

Verify at the official NPI Registry.