Individual provider Active NPI

Sandra Nelson, LPC

  • Professional Counselor
  • Mount Pleasant, SC
National Provider Identifier
1003244716
Registry record updated Jul 18, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
5595 Issued in SC
Practice address
782 Johnnie Dodds Blvd Ste I
Mount Pleasant, SC 29464-3051
Phone
(843) 300-9105
Fax
(843) 284-3931
NPI assigned
Oct 16, 2013
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 18, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X 5595 SC Primary

Addresses

Primary practice location

782 Johnnie Dodds Blvd Ste I
Mount Pleasant, SC 29464-3051

Mailing address

633 Highwood Cir
Charleston, SC 29412-9004
Phone (843) 300-9105

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
I20240807004695 SC Practitioner - Mental Health Counselor 9537606587 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 1994
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

782 Johnnie Dodds Blvd
Suite I
Mount Pleasant, SC 29464-3051
Phone (843) 300-9105

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Sandra Nelson LLC Professional CurrentSince Jun 18, 2024 Accepting new patients
Coastal Tides Counseling Mental Health PastSince Feb 19, 2018 Accepting new patients

Locations

782 Johnnie Dodds Blvd
Ste I
Mt Pleasant, SC 29464
Phone (843) 300-9105

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": "1381881600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1721260800000",
    "number": "1003244716",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "633 HIGHWOOD CIR",
            "city": "CHARLESTON",
            "state": "SC",
            "postal_code": "294129004",
            "telephone_number": "843-300-9105"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "782 JOHNNIE DODDS BLVD STE I",
            "city": "MOUNT PLEASANT",
            "state": "SC",
            "postal_code": "294643051",
            "telephone_number": "843-300-9105",
            "fax_number": "843-284-3931"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NELSON",
        "first_name": "SANDRA",
        "credential": "LPC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-10-16",
        "last_updated": "2024-07-18",
        "certification_date": "2024-07-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "SC",
            "license": "5595",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mount Pleasant, SC

Sources for this page

Verify at the official NPI Registry.