Individual provider Active NPI

Mary Goldin, PMHNP-BC

  • Psychiatric/Mental Health Nurse Practitioner
  • Columbia, SC
National Provider Identifier
1093368169
Registry record updated Oct 19, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
22762 Issued in SC
Practice address
115 Atrium Way Ste 221
Columbia, SC 29223-6383
Phone
(854) 205-4571
NPI assigned
Jul 18, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 19, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 22762 SC Primary
Psychiatry Physician 2084P0800X 22762 SC

Addresses

Primary practice location

115 Atrium Way Ste 221
Columbia, SC 29223-6383

Mailing address

115 Atrium Way Ste 221
Columbia, SC 29223-6383

Other practice location 1

502 Cherry Rd Ste 201202
Rock Hill, SC 29732-3118
Phone (829) 213-6425

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: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20191219002445 SC Practitioner - Nurse Practitioner 4385078625 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Charleston Counseling Center PCGroup PAC ID 6204125107, 186 clinicians

Practice addresses (Care Compare)

115 Atrium Way
Suite 221
Columbia, SC 29223-6383
Phone (843) 501-1099

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
22762SCMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Charleston Counseling Center PC CurrentSince Apr 4, 2024 Accepting new patients
Myrtle Beach Counseling Center PastSince Aug 6, 2019 Accepting new patients

Locations

4800 N Scottsdale Rd
Ste 2500
Scottsdale, AZ 85251
Phone (253) 346-0392

3600 Forest Dr
Ste 302
Columbia, SC 29204
Phone (803) 699-8887

115 Atrium Way
Ste 221
Columbia, SC 29223
Phone (803) 699-8887

871 Lowcountry Blvd
Ste 200
Mt Pleasant, SC 29464
Phone (253) 346-0137

502 Cherry Rd
Ste 201202
Rock Hill, SC 29732
Phone (829) 213-6425

502 Cherry Rd
Ste 201
Rock Hill, SC 29732
Phone (678) 763-5994

Interoperability endpoints

  • Direct secure messaging: lifestancehealth.marygoldin@149035.advancedmd-direct.com

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1563408000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1760832000000",
    "number": "1093368169",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "115 ATRIUM WAY STE 221",
            "city": "COLUMBIA",
            "state": "SC",
            "postal_code": "292236383"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "115 ATRIUM WAY STE 221",
            "city": "COLUMBIA",
            "state": "SC",
            "postal_code": "292236383",
            "telephone_number": "854-205-4571"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "502 Cherry Rd Ste 201202",
            "address_purpose": "LOCATION",
            "city": "Rock Hill",
            "state": "SC",
            "postal_code": "297323118",
            "country_code": "US",
            "telephone_number": "829-213-6425",
            "fax_number": "843-405-2040",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GOLDIN",
        "first_name": "MARY",
        "name_prefix": "Ms.",
        "credential": "PMHNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-07-18",
        "last_updated": "2025-10-19",
        "certification_date": "2025-10-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "SC",
            "license": "22762",
            "primary": true
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "SC",
            "license": "22762",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Columbia, SC

Sources for this page

Verify at the official NPI Registry.