James Van Jefferson, LISW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

15512 Issued in SC

Practice address

5110 Fairfield Rd
Columbia, SC 29203-4323

Phone

(803) 893-7019

NPI assigned

Sep 30, 2020

Last updated

Jul 18, 2023By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Other names 1

• James Van Jefferson Professional name

Medicare fee-for-service enrollment

Enrolled in SC, DC2 enrollments

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 2

Specialty

Clinical Social Worker

Education

Other, 2020

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Eau Claire Cooperative Health Center, Inc.

  • Federally Qualified Health Center (FQHC)
  • Columbia, SC
  • NPI 1346249430

  Social Worker

  Medicare reassignment NPD
• Grow Healthcare Group PA

  • Mental Health Counselor
  • Miami, FL
  • NPI 1245845932

  Clinical, DC

  Medicare reassignment NPD
• Eau Claire Cooperative Health Center ,Inc.

  dba Cooperative Health @ CAMH

  • Federally Qualified Health Center (FQHC)
  • Columbia, SC
  • NPI 1588375653
  NPD
• Thrive Counseling LLC

  dba Thriveworks

  • Mental Health Counselor
  • Lynchburg, VA
  • NPI 1215181300
  NPD
• Eau Claire Cooperative Health Center, Inc

  dba Eau Claire Behavioral Medicine

  • Federally Qualified Health Center (FQHC)
  • Columbia, SC
  • NPI 1992018949
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1601424000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1689638400000",
    "number": "1932716172",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 740013",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303740013",
            "telephone_number": "312-733-9730",
            "fax_number": "773-866-8014"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5110 FAIRFIELD RD",
            "city": "COLUMBIA",
            "state": "SC",
            "postal_code": "292034323",
            "telephone_number": "803-893-7019"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4605 Monticello Rd Bldg B",
            "address_purpose": "LOCATION",
            "city": "Columbia",
            "state": "SC",
            "postal_code": "292034156",
            "country_code": "US",
            "telephone_number": "803-714-0266",
            "fax_number": "803-753-6333",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JEFFERSON",
        "first_name": "JAMES",
        "middle_name": "VAN",
        "name_prefix": "Mr.",
        "credential": "LISW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-09-30",
        "last_updated": "2023-07-18",
        "certification_date": "2023-07-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "SC",
            "license": "15512",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "SC",
            "license": "15512",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JAMES",
            "last_name": "JEFFERSON",
            "middle_name": "VAN",
            "credential": "LISW",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

• Laura Nichole Jeffcoat, PHARMD
• Iris Jeffcoat,, M.B.A, L.P.C.
• Jefferson Wellness and Consulting LLC
• Andrew Jefferson, DMD
• Ervin B Jefferson
• Lanita Jefferson, LPC
• Lindsey Jefferson, MCD, CCC-SLP
• Quanetta Jefferson
• Tyvon Jefferson
• Kelsey Jeffery

• Clinical Social Worker in Columbia, SC
• Providers in Columbia, SC by specialty
• Clinical Social Worker in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 18, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.