NPIMap

Organization Active NPI

South Carolina Online Counseling and Group Therapy, LLC

  • Professional Counselor
  • Ridgeland, SC
National Provider Identifier
1154928448
Registry record updated Oct 8, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
Legal business name
SOUTH CAROLINA ONLINE COUNSELING AND GROUP THERAPY, LLC
Practice address
61 Riverwalk Blvd Ste H
Ridgeland, SC 29936-3252
Phone
(843) 636-5017
Fax
(843) 206-0256
NPI assigned
Oct 8, 2020
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 8, 2020

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

Authorized official

Name
Leigh Diotalevi, LISW-CPNPI 1215394838
Title
Administrator
Phone
(843) 636-5017

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Professional CounselorGroup: 193400000X SINGLE SPECIALTY GROUP 101YP2500X Primary

Addresses

Primary practice location

61 Riverwalk Blvd Ste H
Ridgeland, SC 29936-3252

Mailing address

61 Riverwalk Blvd Ste H
Ridgeland, SC 29936-3252
Phone (843) 636-5017

National Provider Directory

National Provider Directory

Locations

61 Riverwalk Blvd
Ste H
Ridgeland, SC 29936
Phone (843) 636-5017

Practitioners & affiliated clinicians

Practitioners 18

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 18

NPI Registry JSON

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

{
    "created_epoch": "1602115200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1602115200000",
    "number": "1154928448",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "61 RIVERWALK BLVD STE H",
            "city": "RIDGELAND",
            "state": "SC",
            "postal_code": "299363252",
            "telephone_number": "843-636-5017",
            "fax_number": "843-206-0256"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "61 RIVERWALK BLVD STE H",
            "city": "RIDGELAND",
            "state": "SC",
            "postal_code": "299363252",
            "telephone_number": "843-636-5017",
            "fax_number": "843-206-0256"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTH CAROLINA ONLINE COUNSELING AND GROUP THERAPY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-10-08",
        "last_updated": "2020-10-08",
        "certification_date": "2020-10-08",
        "status": "A",
        "authorized_official_last_name": "DIOTALEVI",
        "authorized_official_first_name": "LEIGH",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "843-636-5017",
        "authorized_official_credential": "LISW-CP"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Counselor, Professional",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ridgeland, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 8, 2020; 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.