NPIMap

Organization Active NPI

Columbia Counseling Center/Columbia Behavioral Medicine, P.a.

  • Professional Counselor
  • Columbia, SC
National Provider Identifier
1073560264
Registry record updated Oct 9, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
Legal business name
COLUMBIA COUNSELING CENTER/COLUMBIA BEHAVIORAL MEDICINE, P.A.
Practice address
900 Saint Andrews Rd
Columbia, SC 29210-5816
Phone
(803) 731-4708
Fax
(803) 612-1206
NPI assigned
May 31, 2006
Last updated
Oct 9, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 9, 2024

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

Authorized official

Name
Mr. Darrel Gene Shaver, PH.D., LPCNPI 1598706798
Title
President
Phone
(803) 731-4708

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 4

Specialty (taxonomy)CodeLicenseStatePrimary
Professional CounselorGroup: 193200000X MULTI-SPECIALTY GROUP 101YP2500X Primary
Counseling PsychologistGroup: 193200000X MULTI-SPECIALTY GROUP 103TC1900X
Clinical Social WorkerGroup: 193200000X MULTI-SPECIALTY GROUP 1041C0700X
Marriage & Family TherapistGroup: 193200000X MULTI-SPECIALTY GROUP 106H00000X

Addresses

Primary practice location

900 Saint Andrews Rd
Columbia, SC 29210-5816

Mailing address

900 Saint Andrews Rd
Columbia, SC 29210-5816
Phone (803) 731-4708

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SC

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20050422000593 SC Part B Supplier - Clinic/Group Practice 4880632496 Receives reassigned benefits from 4 practitioners
Practice locations: Columbia, SC

National Provider Directory

National Provider Directory

Locations

900 Saint Andrews Rd
Columbia, SC 29210
Phone (803) 731-4708

Practitioners & affiliated clinicians

Practitioners 12

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1149033600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1728432000000",
    "number": "1073560264",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "900 SAINT ANDREWS RD",
            "city": "COLUMBIA",
            "state": "SC",
            "postal_code": "292105816",
            "telephone_number": "803-731-4708",
            "fax_number": "803-612-1206"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "900 SAINT ANDREWS RD",
            "city": "COLUMBIA",
            "state": "SC",
            "postal_code": "292105816",
            "telephone_number": "803-731-4708",
            "fax_number": "803-612-1206"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COLUMBIA COUNSELING CENTER/COLUMBIA BEHAVIORAL MEDICINE, P.A.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-31",
        "last_updated": "2024-10-09",
        "certification_date": "2024-10-09",
        "status": "A",
        "authorized_official_last_name": "SHAVER",
        "authorized_official_first_name": "DARREL",
        "authorized_official_middle_name": "GENE",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "803-731-4708",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "PH.D., LPC"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Professional",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "103TC1900X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist, Counseling",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Marriage & Family Therapist",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Columbia, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 9, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.