The Palmetto Center for Psychological Assessment, LLC

Primary specialty

Community/Behavioral Health AgencyTaxonomy code 251S00000X

License

828 Issued in SC

Legal business name

THE PALMETTO CENTER FOR PSYCHOLOGICAL ASSESSMENT, LLC

Practice address

123 Library Hill LN
Suite B
Lexington, SC 29072-3895

Phone

(803) 358-9410

Fax

(803) 358-9409

NPI assigned

Nov 16, 2011

Organization subpart

No

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

Authorized official

Name

A Nicholas Depace, PH,D.

Title

Sole Proprietor

Phone

(803) 358-9410

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

Practitioners 1

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

• A. Nicholas Depace, PH.D.

  • Clinical Psychologist
  • Lexington, SC
  • NPI 1982755054
  NPD (past)

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

{
    "created_epoch": "1321401600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1321401600000",
    "number": "1174800387",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1438",
            "city": "LEXINGTON",
            "state": "SC",
            "postal_code": "290711438",
            "telephone_number": "803-358-9410",
            "fax_number": "803-358-9409"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "123 LIBRARY HILL LN",
            "address_2": "SUITE B",
            "city": "LEXINGTON",
            "state": "SC",
            "postal_code": "290723895",
            "telephone_number": "803-358-9410",
            "fax_number": "803-358-9409"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THE PALMETTO CENTER FOR PSYCHOLOGICAL ASSESSMENT, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-11-16",
        "last_updated": "2011-11-16",
        "status": "A",
        "authorized_official_last_name": "DEPACE",
        "authorized_official_first_name": "A",
        "authorized_official_middle_name": "NICHOLAS",
        "authorized_official_title_or_position": "SOLE PROPRIETOR",
        "authorized_official_telephone_number": "803-358-9410",
        "authorized_official_credential": "PH,D."
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "SC",
            "license": "828",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "PS0354",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Nakea Michelle Terry
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• The Arc of the Midlands, Inc
• The Braces Place
• The Flowered Brain, LLC
• Megan Theiler
• Therapy Works LLC
• Alfred Thomas Jr., LPC
• Angela Amick Thomas, FNP-C, AGACNP-BC
• Caroline N Thomas, DMD

• Community/Behavioral Health Agency in Lexington, SC
• Providers in Lexington, 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 Nov 16, 2011; 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.