Pee Dee Mental Health Center

Primary specialty

Community/Behavioral Health AgencyTaxonomy code 251S00000X

Legal business name

PEE DEE MENTAL HEALTH CENTER

Practice address

675 N Matthews Rd
Lake City, SC 29560-7027

Phone

(843) 394-7600

NPI assigned

Mar 26, 2007

Last updated

Aug 22, 2020By 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

Mr. Cedric Jevon Evans, BSW

Title

Human Services Specialist I

Phone

(843) 394-7600

Specialties & licenses 1

Addresses

Other identifiers 1

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

{
    "created_epoch": "1174867200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1174641666",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "125 E CHEVES ST",
            "city": "FLORENCE",
            "state": "SC",
            "postal_code": "295062526",
            "telephone_number": "843-317-4089",
            "fax_number": "843-317-4096"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "675 N MATTHEWS RD",
            "city": "LAKE CITY",
            "state": "SC",
            "postal_code": "295607027",
            "telephone_number": "843-394-7600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PEE DEE MENTAL HEALTH CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-26",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "EVANS",
        "authorized_official_first_name": "CEDRIC",
        "authorized_official_middle_name": "JEVON",
        "authorized_official_title_or_position": "HUMAN SERVICES SPECIALIST I",
        "authorized_official_telephone_number": "843-394-7600",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "BSW"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "376241",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Palmetto Primary Care Physicians, LLC
• Parsons Companion Care, LLC
• Jameel Pearson
• Pee Dee Diabetic Consultants,LLC
• Pee Dee Mental Health
• Pee Dee Physical Therapy, Inc.
• Pee Deediabetic Consultants
• Alice Washington Peterson, LMT
• Andrea Phillips, DPT
• Piggly Wiggly Lake City Inc (price wise pharmacy # 48)

• Community/Behavioral Health Agency in Lake City, SC
• Providers in Lake City, SC by specialty
• Community/Behavioral Health Agency in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 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.