Lucretia Beanica Tillman, LCSWA

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

P011435 Issued in NC

Practice address

1020 Wylie Springs Cir Apt 17-201
Clover, SC 29710-0500

Phone

(980) 328-6234

NPI assigned

Jun 20, 2018

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NC

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

Specialty

Clinical Social Worker

Education

Other, 2017

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Scotland Memorial Hospital, IncGroup PAC ID 0648208504, 259 clinicians

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 and National Provider Directory roles.

• Scotland Memorial Hospital Inc

  • Vascular Surgery Physician
  • Laurinburg, NC
  • NPI 1477791507
  Medicare reassignment Care Compare group NPD
• Scotland Memorial Hospital Inc

  • General Practice Physician
  • Laurinburg, NC
  • NPI 1518951144
  NPD

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

{
    "created_epoch": "1529452800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1529452800000",
    "number": "1942794243",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1020 WYLIE SPRINGS CIR APT 17-201",
            "city": "CLOVER",
            "state": "SC",
            "postal_code": "297100500",
            "telephone_number": "980-328-6234"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1020 WYLIE SPRINGS CIR APT 17-201",
            "city": "CLOVER",
            "state": "SC",
            "postal_code": "297100500",
            "telephone_number": "980-328-6234"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TILLMAN",
        "first_name": "LUCRETIA",
        "middle_name": "BEANICA",
        "name_prefix": "Miss",
        "credential": "LCSWA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-06-20",
        "last_updated": "2018-06-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NC",
            "license": "P011435",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Joy Renee Stephens, CNA
• Kharen Marie Stewart
• Andrew Thomas Sullivan
• Sneha Suresh Babu
• Thrive Family Services
• Steven Paul Van Dyke, OTR/L
• Vanessa N Vargas, DMD
• Christine Vazquez, LPC-A, ATR-BC
• Jennifer Wagner, M.D.
• Walker Physical Therapy & Wellness, LLC

• Clinical Social Worker in Clover, SC
• Providers in Clover, 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 Jun 20, 2018; 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.