Individual provider Active NPI

Michael A Jayne

  • Professional Counselor
  • Charleston, SC
National Provider Identifier
1144499690
Registry record updated Apr 8, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
6204 Issued in SC
Practice address
2100 Charlie Hall Blvd
Charleston, SC 29414-5832
Phone
(843) 852-4100
NPI assigned
Feb 28, 2008
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 8, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X 6204 SC Primary

Addresses

Primary practice location

2100 Charlie Hall Blvd
Charleston, SC 29414-5832

Mailing address

2100 Charlie Hall Blvd
Charleston, SC 29414-5832

Other identifiers 1

IdentifierTypeStateIssuer
1760596480MedicaidSC

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240626001584 SC Practitioner - Mental Health Counselor 9133663602 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Charleston Counseling Center PCGroup PAC ID 6204125107, 186 clinicians

Practice addresses (Care Compare)

171 Ashley Ave
Charleston, SC 29425-8908
Phone (843) 792-1414

871 Lowcountry Blvd
Suite 200
Mount Pleasant, SC 29464-3096
Phone (843) 501-1099

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
6204SCMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Myrtle Beach Counseling Center Mental Health CurrentSince Apr 14, 2024 Accepting new patients
University Medical Associates of the Medical University of South Carol CurrentSince Jul 22, 2024 Accepting new patients
University Medical Associates of the Medical University of South Carol CurrentSince Jul 22, 2024 Accepting new patients
Charleston Counseling Center PC Mental Health CurrentSince Apr 14, 2024 Accepting new patients

Locations

171 Ashley Ave
Charleston, SC 29425
Phone (843) 792-2123

2100 Charlie Hall Blvd
Charleston, SC 29414
Phone (843) 212-8968

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

Organizations & group practices 4

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": "1204156800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1712534400000",
    "number": "1144499690",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2100 CHARLIE HALL BLVD",
            "city": "CHARLESTON",
            "state": "SC",
            "postal_code": "294145832"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2100 CHARLIE HALL BLVD",
            "city": "CHARLESTON",
            "state": "SC",
            "postal_code": "294145832",
            "telephone_number": "843-852-4100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JAYNE",
        "first_name": "MICHAEL",
        "middle_name": "A",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-02-28",
        "last_updated": "2024-04-08",
        "certification_date": "2024-04-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "SC",
            "license": "6204",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1760596480",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Charleston, SC

Sources for this page

Verify at the official NPI Registry.