Statewide Outreach Project LLC

Primary specialty

Community/Behavioral Health AgencyTaxonomy code 251S00000X

Legal business name

STATEWIDE OUTREACH PROJECT LLC

Practice address

396 Saint Paul St
Suite 1111 Carolina Office Building
Orangeburg, SC 29115-5465

Phone

(888) 992-5534

Fax

(866) 408-8142

NPI assigned

Aug 30, 2006

Organization subpart

No

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

Authorized official

Name

Dr. Juenarrl Keith, D.MIN.

Title

Executive Minister

Phone

(843) 993-5534

Specialties & licenses 4

Addresses

Locations

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

{
    "created_epoch": "1156896000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1461110400000",
    "number": "1043320146",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2863",
            "city": "ORANGEBURG",
            "state": "SC",
            "postal_code": "291162863",
            "fax_number": "866-408-8142"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "396 SAINT PAUL ST",
            "address_2": "SUITE 1111 CAROLINA OFFICE BUILDING",
            "city": "ORANGEBURG",
            "state": "SC",
            "postal_code": "291155465",
            "telephone_number": "888-992-5534",
            "fax_number": "866-408-8142"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "STATEWIDE OUTREACH PROJECT LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-30",
        "last_updated": "2016-04-20",
        "status": "A",
        "authorized_official_last_name": "KEITH",
        "authorized_official_first_name": "JUENARRL",
        "authorized_official_title_or_position": "EXECUTIVE MINISTER",
        "authorized_official_telephone_number": "843-993-5534",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.MIN."
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "104100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Social Worker",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Charles T Staples Jr., MD
• Leslie Starks
• State of South Carolina
• Bridget Hollis Staten, PH.D, LPC, CRC
• David Staten, PH.D,LPC, NCC,CRC
• Stefan Montgomery MD Family & Sports Medicine, PA
• Stellar Home Health LLC
• Jennifer Renee Stephens
• Quai Stephens
• Sandra Stephens, MD

• Community/Behavioral Health Agency in Orangeburg, SC
• Providers in Orangeburg, SC by specialty
• Community/Behavioral Health Agency in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 20, 2016; 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.