Individual provider Active NPI

Camille B. Wood, LPC

  • Mental Health Counselor
  • Columbia, SC
National Provider Identifier
1063001592
Registry record updated Nov 21, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
7697 Issued in SC
Practice address
3555 Harden Street Ext Ste 141
Columbia, SC 29203-6894
Phone
(803) 434-4300
Fax
(803) 434-4351
NPI assigned
Jan 11, 2021
Last updated
Nov 21, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 21, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X 7697 SC Primary

Addresses

Primary practice location

3555 Harden Street Ext Ste 141
Columbia, SC 29203-6894

Mailing address

300 E McBee Ave FL 4
Greenville, SC 29601-2842
Phone (864) 522-8603

Other practice location 1

1612 Marion St Ste 214
Columbia, SC 29201-2939
Phone (803) 369-8124

Electronic endpoints 1

TypeEndpointUseAffiliation
Other URL URL

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
I20240105002537 SC Practitioner - Mental Health Counselor 9234580051 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
University of South Carolina School of Medicine, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Prisma Health Medical Group-MidlandsGroup PAC ID 5991099707, 1,040 clinicians

Practice addresses (Care Compare)

115 N Sumter St
Suite 300
Sumter, SC 29150-4967
Phone (803) 775-1550

2 Medical Park Rd
Suite 506
Columbia, SC 29203-6876
Phone (803) 540-1000

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
7697SCMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Prisma Health Medical Group-Midlands CurrentSince Jan 1, 2024 Accepting new patients
Prisma Health Medical Group-Midlands CurrentSince Jan 1, 2024 Accepting new patients

Locations

2 Medical Park Rd
Ste 506
Columbia, SC 29203
Phone (803) 434-3930

3555 Harden Street Ext
Ste 141
Columbia, SC 29203
Phone (803) 434-4303

300 E McBee Ave
Fl 4
Greenville, SC 29601
Phone (864) 522-8615

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1610323200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1700524800000",
    "number": "1063001592",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "300 E MCBEE AVE FL 4",
            "city": "GREENVILLE",
            "state": "SC",
            "postal_code": "296012842",
            "telephone_number": "864-522-8603"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3555 HARDEN STREET EXT STE 141",
            "city": "COLUMBIA",
            "state": "SC",
            "postal_code": "292036894",
            "telephone_number": "803-434-4300",
            "fax_number": "803-434-4351"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1612 Marion St Ste 214",
            "address_purpose": "LOCATION",
            "city": "Columbia",
            "state": "SC",
            "postal_code": "292012939",
            "country_code": "US",
            "telephone_number": "803-369-8124",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WOOD",
        "first_name": "CAMILLE",
        "middle_name": "B.",
        "credential": "LPC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-01-11",
        "last_updated": "2023-11-21",
        "certification_date": "2023-11-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "SC",
            "license": "7697",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "URL",
            "affiliation": "N",
            "address_1": "1612 Marion St Ste 214",
            "city": "Columbia",
            "state": "SC",
            "country_code": "US",
            "postal_code": "292012939",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Columbia, SC

Sources for this page

Verify at the official NPI Registry.