Organization Active NPI

Palmetto Psychiatry & Wellness

  • Psychiatric/Mental Health Nurse Practitioner
  • Seneca, SC
National Provider Identifier
1154196376
Registry record updated Jun 20, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
Legal business name
PALMETTO PSYCHIATRY & WELLNESS
Practice address
815 Robin Dr Ste B
Seneca, SC 29678-2653
Phone
(864) 614-1555
Fax
(312) 535-6816
NPI assigned
Nov 17, 2023
Last updated
Jun 20, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 20, 2024

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

Authorized official

Name
Celeste Marie Mendez, APRN
Title
Owner
Phone
(860) 878-8447

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X NU Primary

Addresses

Primary practice location

815 Robin Dr Ste B
Seneca, SC 29678-2653

Mailing address

PO Box 562
Seneca, SC 29679-0562
Phone (860) 878-8447

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SC

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20240816001182 SC Part B Supplier - Clinic/Group Practice 7012455421 Receives reassigned benefits from 1 practitioner
Practice locations: Seneca, SC

National Provider Directory

National Provider Directory

Locations

108 E North 1st St
#E
Seneca, SC 29678

815 Robin Dr
Ste B
Seneca, SC 29678
Phone (864) 614-1555

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1700179200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1718841600000",
    "number": "1154196376",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 562",
            "city": "SENECA",
            "state": "SC",
            "postal_code": "296790562",
            "telephone_number": "860-878-8447",
            "fax_number": "312-535-6816"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "815 ROBIN DR STE B",
            "city": "SENECA",
            "state": "SC",
            "postal_code": "296782653",
            "telephone_number": "864-614-1555",
            "fax_number": "312-535-6816"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PALMETTO PSYCHIATRY & WELLNESS",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-11-17",
        "last_updated": "2024-06-20",
        "certification_date": "2024-06-20",
        "status": "A",
        "authorized_official_last_name": "MENDEZ",
        "authorized_official_first_name": "CELESTE",
        "authorized_official_middle_name": "MARIE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "860-878-8447",
        "authorized_official_credential": "APRN"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Seneca, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 20, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.