Phyllis Kathleen Azzarito
Individual provider Active NPI Professional Counselor · Greenville, SC
NPI 1013687797 · NPPES record last updated Sep 15, 2021
Key facts
- NPI
- 1013687797
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Professional Counselor 101YP2500X
- License
- 7844 (SC)
- Practice address
- 68 Pointe Cir Ste 3201
Greenville, SC 29615-6307 - Phone
- (855) 284-7483
- Fax
- (617) 807-0958
- NPI assigned
- Sep 15, 2021
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 10
Medicare Care Compare profile
- Specialty
- Mental Health Counselor
- Education
- Other, 1993
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
- Lifesource of North Carolina
Practice addresses (Care Compare)
939 Springdale Dr
Clinton, SC 29325-7266
Phone (910) 742-9243
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in SC
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: No · Power mobility devices: No · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20240215002236 | SC | Practitioner - Mental Health Counselor | 4981048188 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
Practice roles (3 of 4)
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Lifesource of North Carolina | Current |
Accepting new patients | |
| Lifesource of North Carolina | Current |
Accepting new patients | |
| Thrive Counseling LLC | Current |
Accepting new patients |
Locations
68 Pointe Cir
Ste 3201
Greenville, SC 29615
Phone (864) 479-1212
1915 Ebenezer Rd
Rock Hill, SC 29732
Phone (305) 866-9951
1000 Jefferson St
Ste 2C
Lynchburg, VA 24504
Phone (434) 528-3263
Networks
- devoted network organization-92131eb0-09f2-4173-a140-cf7b381f0cf1
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | 7844 | SC | Yes |
Addresses
Primary practice location
68 Pointe Cir Ste 3201
Greenville, SC 29615-6307
Mailing address
1000 Jefferson St Ste 2C
Lynchburg, VA 24504-1724
Phone (855) 284-7483
Other providers in Greenville, SC
- Amber Joan Ayers
- Whitney Gray Ayers
- Sherif Ayoub
- Gail D Azain
- Sherin Azmy
- Michael Azzer
- B Giles, LLC
- Taylah Babb
- Michael Arthur Babcock
- Roberta Babcock
All providers in Greenville, SC · Professional Counselor in South Carolina
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 15, 2021. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.