NPIMap

Organization Active NPI

Carolina Behavioral Counseling

  • Professional Counselor
  • Summerville, SC
National Provider Identifier
1053879007
Registry record updated Apr 27, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
Legal business name
CAROLINA BEHAVIORAL COUNSELING
Practice address
110 Ashley Bluffs Rd
Summerville, SC 29485-6043
Phone
(803) 939-6747
NPI assigned
Mar 8, 2019
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 27, 2022

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

Authorized official

Name
Samantha Brenner Gautier, LPCNPI 1346708377
Title
Owner, LPC
Phone
(803) 939-6747

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Professional CounselorGroup: 193400000X SINGLE SPECIALTY GROUP 101YP2500X Primary
Mental Health Clinic/Center (Including Community Mental Health Center) 261QM0801X

Addresses

Primary practice location

110 Ashley Bluffs Rd
Summerville, SC 29485-6043

Mailing address

110 Ashley Bluffs Rd
Summerville, SC 29485-6043
Phone (908) 334-8117

National Provider Directory

National Provider Directory

Locations

4500 Fort Jackson Blvd
Columbia, SC 29209
Phone (803) 782-1008

887 Johnnie Dodds Blvd
Ste 223
Mount Pleasant, SC 29464
Phone (803) 939-6747

Practitioners & affiliated clinicians

Practitioners 6

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

NPI Registry JSON

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

{
    "created_epoch": "1552003200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1651017600000",
    "number": "1053879007",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "110 ASHLEY BLUFFS RD",
            "city": "SUMMERVILLE",
            "state": "SC",
            "postal_code": "294856043",
            "telephone_number": "908-334-8117"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "110 ASHLEY BLUFFS RD",
            "city": "SUMMERVILLE",
            "state": "SC",
            "postal_code": "294856043",
            "telephone_number": "803-939-6747"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CAROLINA BEHAVIORAL COUNSELING",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-03-08",
        "last_updated": "2022-04-27",
        "certification_date": "2022-04-27",
        "status": "A",
        "authorized_official_last_name": "BRENNER GAUTIER",
        "authorized_official_first_name": "SAMANTHA",
        "authorized_official_title_or_position": "OWNER, LPC",
        "authorized_official_telephone_number": "803-939-6747",
        "authorized_official_credential": "LPC"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Counselor, Professional",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Summerville, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 27, 2022; 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.