Waccamaw Center for Mental Health

Primary specialty

Mental Health Clinic/Center (Including Community Mental Health Center)Taxonomy code 261QM0801X

Legal business name

WACCAMAW CENTER FOR MENTAL HEALTH

Practice address

164 Waccamaw Medical Park Dr
Conway, SC 29526-8903

Phone

(843) 347-4888

NPI assigned

Aug 26, 2019

Organization subpart

Yes

Parent organization

SOUTH CAROLINA DEPARTMENT OF MENTAL HEALTHAs reported in NPPES

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

Authorized official

Name

Mr. Matthew J Beauchemin, BA/BS

Title

Human Services Coordinator I

Phone

(843) 347-4888

Specialties & licenses 1

Addresses

Part of

Waccamaw Center for Mental Health

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

{
    "created_epoch": "1566777600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1566777600000",
    "number": "1093362881",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "164 WACCAMAW MEDICAL PARK DR",
            "city": "CONWAY",
            "state": "SC",
            "postal_code": "295268903",
            "telephone_number": "843-347-4888"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "164 WACCAMAW MEDICAL PARK DR",
            "city": "CONWAY",
            "state": "SC",
            "postal_code": "295268903",
            "telephone_number": "843-347-4888"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WACCAMAW CENTER FOR MENTAL HEALTH",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "SOUTH CAROLINA DEPARTMENT OF MENTAL HEALTH",
        "enumeration_date": "2019-08-26",
        "last_updated": "2019-08-26",
        "status": "A",
        "authorized_official_last_name": "BEAUCHEMIN",
        "authorized_official_first_name": "MATTHEW",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "HUMAN SERVICES COORDINATOR I",
        "authorized_official_telephone_number": "843-347-4888",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "BA/BS"
    },
    "taxonomies": [
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Whitney Lee Vovou, M.S., LPC
• Alysia A. Vulgaris
• Amanda D. Vuppala, M.D.
• Srinivas Vuppala, MD
• Waccamaw Cardiology PC
• Waccamaw Pediatric Dental Care, LLC
• Waccamaw Primary Care,LLC
• Waccamaws Health and Wellness Services LLC
• Wal-Mart Stores East LP
• Wal-Mart Stores East LP

• Mental Health Clinic/Center (Including Community Mental Health Center) in Conway, SC
• Providers in Conway, SC by specialty
• Mental Health Clinic/Center (Including Community Mental Health Center) in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 26, 2019; 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.