The Unumb Center for Neurodevelopment

Primary specialty

PsychologistTaxonomy code 103T00000X

License

1319 Issued in SC

Legal business name

THE UNUMB CENTER FOR NEURODEVELOPMENT

Practice address

1505 Blanding St
Columbia, SC 29201-2906

Phone

(803) 929-0011

Fax

(803) 569-1054

NPI assigned

Feb 3, 2016

Organization subpart

No

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

Authorized official

Name

Anslie Callaway PatrickNPI 1730563313

Title

Executive Director

Phone

(803) 929-0011

Specialties & licenses 2

Addresses

Other identifiers 2

Other names 1

• Autism Academy of South Carolina Former legal business name

Tax ID family

Autism Academy of South Carolina2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• The Unumb Center for Neurodevelopment

  • Behavior Analyst
  • Columbia, SC
  • NPI 1184984742
  NPD tax ID

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Anslie Callaway Patrick, BCBA

  • Behavior Analyst
  • Columbia, SC
  • NPI 1730563313
  NPD Authorized official
• Jessica Hudson

  • Behavior Analyst
  • Charleston, SC
  • NPI 1083207534
  NPD

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

{
    "created_epoch": "1454457600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1613088000000",
    "number": "1023476280",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1505 BLANDING ST",
            "city": "COLUMBIA",
            "state": "SC",
            "postal_code": "292012906",
            "telephone_number": "803-929-0011",
            "fax_number": "803-569-1054"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1505 BLANDING ST",
            "city": "COLUMBIA",
            "state": "SC",
            "postal_code": "292012906",
            "telephone_number": "803-929-0011",
            "fax_number": "803-569-1054"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THE UNUMB CENTER FOR NEURODEVELOPMENT",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-02-03",
        "last_updated": "2021-02-12",
        "certification_date": "2021-02-12",
        "status": "A",
        "authorized_official_last_name": "PATRICK",
        "authorized_official_first_name": "ANSLIE",
        "authorized_official_middle_name": "CALLAWAY",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "803-929-0011"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist",
            "state": "SC",
            "license": "1319",
            "primary": true
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Speech-Language Pathologist",
            "state": "SC",
            "license": "3640",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "GP7205",
            "state": "SC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "GP7206",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Autism Academy of South Carolina",
            "code": "4",
            "type": "Former Legal Business Name"
        },
        {
            "organization_name": "Autism Academy of South Carolina",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

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• Psychologist in Columbia, SC
• Providers in Columbia, SC by specialty
• Psychologist in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 12, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.