BRK Psychiatric Mental Health Services LLC

Primary specialty

Mental Health Clinic/Center (Including Community Mental Health Center)Taxonomy code 261QM0801X

Legal business name

BRK PSYCHIATRIC MENTAL HEALTH SERVICES LLC

Practice address

1156 Old McGraw Rd
Eastover, SC 29044-9116

Phone

(803) 353-2082

Fax

(803) 353-2082

NPI assigned

Jul 20, 2021

Last updated

Jul 20, 2021By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Bernice Kennedy, APRNNPI 1407234909

Title

Psychiatric Mental Health -CNS

Phone

(803) 353-2082

Specialties & licenses 1

Addresses

Other identifiers 1

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.

• Bernice Kennedy

  • Psychiatric/Mental Health Clinical Nurse Specialist
  • Sumter, SC
  • NPI 1407234909
  NPD Authorized official

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

{
    "created_epoch": "1626739200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1626739200000",
    "number": "1174196976",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 90899",
            "city": "COLUMBIA",
            "state": "SC",
            "postal_code": "292901889",
            "telephone_number": "803-353-2082",
            "fax_number": "803-353-2082"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1156 OLD MCGRAW RD",
            "city": "EASTOVER",
            "state": "SC",
            "postal_code": "290449116",
            "telephone_number": "803-353-2082",
            "fax_number": "803-353-2082"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BRK PSYCHIATRIC MENTAL HEALTH SERVICES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-07-20",
        "last_updated": "2021-07-20",
        "certification_date": "2021-07-20",
        "status": "A",
        "authorized_official_last_name": "KENNEDY",
        "authorized_official_first_name": "BERNICE",
        "authorized_official_title_or_position": "PSYCHIATRIC MENTAL HEALTH -CNS",
        "authorized_official_telephone_number": "803-353-2082",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "APRN"
    },
    "taxonomies": [
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "NP3264",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Above All Home Care
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• Carla Nadine Boyd
• Zena Boyd
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• Denise Faye Corpening, RN
• Courtlyn House CRCF
• Antonio Tremon Davis, LISW
• Jerry Rena Delgado, CPHT

• Mental Health Clinic/Center (Including Community Mental Health Center) in Eastover, SC
• Providers in Eastover, SC by specialty
• Mental Health Clinic/Center (Including Community Mental Health Center) in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 20, 2021; 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.