Individual provider Active NPI

Anita Shanel Kaiser, MA, LPC, LCMHC

  • Mental Health Counselor
  • North Charleston, SC
National Provider Identifier
1154055390
Registry record updated Nov 3, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
22072 Issued in NC
Practice address
6650 Rivers Ave Ste 100
North Charleston, SC 29406-4809
Phone
(803) 921-9655
NPI assigned
Jul 13, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 3, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X 22072 NC Primary
Professional Counselor 101YP2500X 9964 SC

Addresses

Primary practice location

6650 Rivers Ave Ste 100
North Charleston, SC 29406-4809

Mailing address

277 Overcup Loop
Summerville, SC 29486-6969
Phone (803) 921-9655

Other identifiers 1

IdentifierTypeStateIssuer
435201MedicaidSC

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SC, NC, VT3 enrollments
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 3

Enrollment IDStateProvider typePAC IDDetails
I20251231001104 SC Practitioner - Mental Health Counselor 9436645298 Reassigns benefits to 1 organization
I20260102002885 NC Practitioner - Mental Health Counselor 9436645298 Reassigns benefits to 1 organization
I20260406003600 VT Practitioner - Mental Health Counselor 9436645298 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2020
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

66 E Flagler St
Miami, FL 33130-1807

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Arts

State licenses

LicenseStateTypeSpecialty
9964SCMDDentist
22072NCMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Grow Healthcare Group PA Mental Health CurrentSince Oct 21, 2025 Accepting new patients

Locations

3511 Shannon Rd
Fl 3
Durham, NC 27707
Phone (201) 293-7689

170 Meeting St
Ste 110
Charleston, SC 29401
Phone (704) 610-1304

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1657670400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1762128000000",
    "number": "1154055390",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "277 OVERCUP LOOP",
            "city": "SUMMERVILLE",
            "state": "SC",
            "postal_code": "294866969",
            "telephone_number": "803-921-9655"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6650 RIVERS AVE STE 100",
            "city": "NORTH CHARLESTON",
            "state": "SC",
            "postal_code": "294064809",
            "telephone_number": "803-921-9655"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KAISER",
        "first_name": "ANITA SHANEL",
        "credential": "MA, LPC, LCMHC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-07-13",
        "last_updated": "2025-11-03",
        "certification_date": "2025-11-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NC",
            "license": "22072",
            "primary": true
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "SC",
            "license": "9964",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "435201",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in North Charleston, SC

Sources for this page

Verify at the official NPI Registry.