NPIMap

Organization Active NPI

Scdjj

  • Community/Behavioral Health Agency
  • Columbia, SC
National Provider Identifier
1144569872
Registry record updated Jan 31, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Behavioral Health AgencyTaxonomy code 251S00000X
License
8850 Issued in SC
Legal business name
SCDJJ
Practice address
5000 Broad River Rd
Golf Unit/Birchwood Campus
Columbia, SC 29212-3532
Phone
(803) 896-4753
NPI assigned
Jan 31, 2013
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 31, 2013

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

Authorized official

Name
Demorrie Lashaun Evans, LMSW
Title
Social Worker
Phone
(803) 896-4753

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Behavioral Health Agency 251S00000X 8850 SC Primary

Addresses

Primary practice location

5000 Broad River Rd
Golf Unit/Birchwood Campus
Columbia, SC 29212-3532

Mailing address

5000 Broad River Rd
Columbia, SC 29212-3532
Phone (803) 896-4753

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1359590400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1359590400000",
    "number": "1144569872",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5000 BROAD RIVER RD",
            "city": "COLUMBIA",
            "state": "SC",
            "postal_code": "292123532",
            "telephone_number": "803-896-4753"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5000 BROAD RIVER RD",
            "address_2": "GOLF UNIT/BIRCHWOOD CAMPUS",
            "city": "COLUMBIA",
            "state": "SC",
            "postal_code": "292123532",
            "telephone_number": "803-896-4753"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SCDJJ",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-01-31",
        "last_updated": "2013-01-31",
        "status": "A",
        "authorized_official_last_name": "EVANS",
        "authorized_official_first_name": "DEMORRIE",
        "authorized_official_middle_name": "LASHAUN",
        "authorized_official_title_or_position": "SOCIAL WORKER",
        "authorized_official_telephone_number": "803-896-4753",
        "authorized_official_credential": "LMSW"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "SC",
            "license": "8850",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Columbia, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 31, 2013; 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.