MR. JORGE ANTONIO PERDOMO (NPI# 1275676892) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1275676892 |
| Entity Type | Individual |
| Full Name | MR. JORGE ANTONIO PERDOMO |
| Credential | LISW |
| Practice Address |
900 Greenville Drive Williamston SC 29697 |
| Mailing Address |
135 Crystal Dr Duncan SC 29334-9320 |
| Practice Telephone | 8648471818 |
| Practice Fax Number | 8648475706 |
| Mailing Telephone | 8644397800 |
| Enumeration Date | 2007-02-14 |
| Last Update Date | 2007-07-08 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1041C0700X |
Social Worker Specialization: Clinical |
Behavioral Health & Social Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| SC | LICENSE # | 7100 | 01 |
| Street Address |
900 GREENVILLE DRIVE |
| City | WILLIAMSTON |
| State | SC |
| Zip Code | 29697 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1447654363 | New Dominion Community Services LLC | Counselor | 900 Greenville Drive, Williamston, SC 29697-0000 | 2014-10-21 |
| 1285839563 | Lou Wingo Rogers | Counselor | 900 Greenville Drive, Williamston, SC 29697 | 2007-06-18 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1760893705 | Daniel Alexander Ellis | Occupational Therapy Assistant | 801 N. Hamilton St., Williamston, SC 29697 | 2014-05-13 |
| 1093134108 | Luz Brown | Pharmacist | 102 Wood Stream Way, Williamston, SC 29697 | 2014-04-16 |
| 1144644410 | Lynne Phillips | Registered Nurse | 804 N. Hamilton Street, Williamston, SC 29697 | 2014-02-07 |
| 1396969556 | Ambucare Ambulance LLC. | Non-emergency Medical Transport (VAN) | 303 Beaverdam Road, Williamston, SC 29697 | 2007-04-12 |
| 1245301985 | Complete Healing & Wellness Center P.a. | Chiropractor | 24 East Main St, Williamston, SC 29697 | 2006-11-13 |
| 1255402905 | Jack D Wise Jr. | Chiropractor | 24 East Main Street, Williamston, SC 29697 | 2006-11-13 |
| 1578634218 | Marylouise Schultz Wise | Chiropractor | 24 East Main St, Williamston, SC 29697 | 2006-11-13 |
| 1730504499 | Robin Crawford | Registered Nurse | 803 N Hamilton St, Williamston, SC 29697-1061 | 2014-03-04 |
| 1104973577 | Anderson County School District One | Local Education Agency (LEA) | 801 N Hamilton St, Williamston, SC 29697-1061 | 2007-01-05 |
| 1033668470 | Tracy Hamlin Redmon | Speech-Language Pathologist | 801 N Hamilton St, Williamston, SC 29697-1061 | 2016-09-27 |
| Find all providers in zip 29697 | ||||
| Taxonomy Code | 1041C0700X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Social Worker |
| Specialization | Clinical |
| A social worker who holds a master’s or doctoral degree in social work from an accredited school of social work in addition to at least two years of post-master’s supervised experience in a clinical setting. The social worker must be licensed, certified, or registered at the clinical level in the jurisdiction of practice. A clinical social worker provides direct services, including interventions focused on interpersonal interactions, intrapsychic dynamics, and life management issues. Clinical social work services are based on bio-psychosocial perspectives. Services consist of assessment, diagnosis, treatment (including psychotherapy and counseling), client-centered advocacy, consultation, evaluation, and prevention of mental illness, emotional, or behavioral disturbances. |
| Notes: Source: National Association of Social Workers, 2008 [7/1/2009: definition modified] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1487192936 | Karen Margaret Newman | Social Worker | 440 E Riverside St, Williamston, MI 48895-1147 | 2017-02-04 |
| 1487018289 | Healing Journey Xvi Inc | Social Worker | 4549 Meridian Rd, Williamston, MI 48895-9417 | 2016-04-07 |
| 1013320449 | Jacqueline Urban | Social Worker | 137 E Newman Rd, Williamston, MI 48895-9329 | 2014-06-03 |
| 1649522459 | Carol Z Way | Social Worker | 870 Hickory Ln, Williamston, MI 48895-1042 | 2012-10-04 |
| 1912264656 | Tracie V Smith | Social Worker | 1403 Eli Bowen Rd, Williamston, NC 27892-7942 | 2012-04-19 |
| 1427365121 | Christie Manning Herring | Social Worker | 210 West Liberty Street, Williamston, NC 27892-0000 | 2010-09-02 |
| 1811158546 | Prosource Therapeutics, LLC | Social Worker | 622 East Blvd, Williamston, NC 27892-2736 | 2008-06-25 |
| 1689706640 | Mary Therese Cavanagh | Social Worker | 3486 Moyer Rd, Williamston, MI 48895-9566 | 2007-03-12 |
| 1306907209 | Norma J Sell | Social Worker | 3971 Woodpass Ln, Williamston, MI 48895-9044 | 2006-12-13 |
| 1861034704 | Young Mind Therapy, LLC | Social Worker | 1235 E Grand River Rd, Williamston, MI 48895-8303 | 2019-10-11 |
| Find all providers in WILLIAMSTON | ||||
| City | WILLIAMSTON |
| Zip Code | 29697 |
Please comment or provide details below to improve the information on MR. JORGE ANTONIO PERDOMO.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.