NPIMap

Organization Active NPI

Clemson Counseling Center, Inc.

  • Mental Health Counselor
  • Clemson, SC
National Provider Identifier
1093916090
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
4325 Issued in SC
Legal business name
CLEMSON COUNSELING CENTER, INC.
Practice address
1011 Tiger Blvd
Suite 610
Clemson, SC 29631-2915
Phone
(864) 654-0322
Fax
(864) 654-0324
NPI assigned
May 29, 2007
Last updated
Aug 22, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Ms. Michele Davenport Eberhart, M. ED., LPC
Title
Licensed Professional Counselor
Phone
(864) 654-0322

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health CounselorGroup: 193400000X SINGLE SPECIALTY GROUP 101YM0800X 4325 SC Primary

Addresses

Primary practice location

1011 Tiger Blvd
Suite 610
Clemson, SC 29631-2915

Mailing address

1011 Tiger Blvd
Suite 610
Clemson, SC 29631-2915
Phone (864) 654-0322

National Provider Directory

National Provider Directory
Tax ID family
Clemson Counseling Center Inc2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1180396800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1093916090",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1011 TIGER BLVD",
            "address_2": "SUITE 610",
            "city": "CLEMSON",
            "state": "SC",
            "postal_code": "296312915",
            "telephone_number": "864-654-0322",
            "fax_number": "864-654-0324"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1011 TIGER BLVD",
            "address_2": "SUITE 610",
            "city": "CLEMSON",
            "state": "SC",
            "postal_code": "296312915",
            "telephone_number": "864-654-0322",
            "fax_number": "864-654-0324"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CLEMSON COUNSELING CENTER, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-29",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "EBERHART",
        "authorized_official_first_name": "MICHELE",
        "authorized_official_middle_name": "DAVENPORT",
        "authorized_official_title_or_position": "LICENSED PROFESSIONAL COUNSELOR",
        "authorized_official_telephone_number": "864-654-0322",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "M. ED., LPC"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Counselor, Mental Health",
            "state": "SC",
            "license": "4325",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Clemson, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.