Active NPI
Michael David Deason, LPC
- Professional Counselor
- Irmo, SC
National Provider Identifier
1124300355
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- 3819
- Practice address
- 7941 Broad River Road
Sandhills Pediatrics
Irmo, SC 29063 - Phone
- (803) 606-4441
- NPI assigned
- Sep 14, 2011
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | 3819 | SC | Primary |
Addresses
Primary practice location
7941 Broad River Road
Sandhills Pediatrics
Irmo, SC 29063
Mailing address
204 Myles Court
Lexington, SC 29072
Phone (803) 606-4441
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 3819 | SC | MD | Physician Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Wellspring Counseling Services, LLC | Professional | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- Professional Counselor
- Irmo, SC
- NPI 1306052451
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1315958400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1315958400000",
"number": "1124300355",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "204 MYLES COURT",
"city": "LEXINGTON",
"state": "SC",
"postal_code": "29072",
"telephone_number": "803-606-4441"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "7941 BROAD RIVER ROAD",
"address_2": "SANDHILLS PEDIATRICS",
"city": "IRMO",
"state": "SC",
"postal_code": "29063",
"telephone_number": "803-606-4441"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DEASON",
"first_name": "MICHAEL",
"middle_name": "DAVID",
"credential": "LPC",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2011-09-14",
"last_updated": "2011-09-14",
"status": "A"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "SC",
"license": "3819",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Irmo, SC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 14, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.