U-Reaach, LLC

Primary specialty

Community/Behavioral Health AgencyTaxonomy code 251S00000X

License

5249 Issued in SC

Legal business name

U-REAACH, LLC

Practice address

104 Red Bluff Street
Clio, SC 29525-4722

Phone

(843) 586-0108

Fax

(843) 586-0108

NPI assigned

Jan 29, 2016

Organization subpart

No

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

Authorized official

Name

Dr. Damien Edward Johnson, PH.D., LPC, CAC-II,

Title

Owner

Phone

(843) 586-0108

Specialties & licenses 3

Addresses

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

{
    "created_epoch": "1454025600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1454025600000",
    "number": "1184082604",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "741 CRAIG CIR",
            "city": "BENNETTSVILLE",
            "state": "SC",
            "postal_code": "295122005",
            "telephone_number": "843-586-0108",
            "fax_number": "843-586-0108"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "104 RED BLUFF STREET",
            "city": "CLIO",
            "state": "SC",
            "postal_code": "295254722",
            "telephone_number": "843-586-0108",
            "fax_number": "843-586-0108"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "U-REAACH, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-01-29",
        "last_updated": "2016-01-29",
        "status": "A",
        "authorized_official_last_name": "JOHNSON",
        "authorized_official_first_name": "DAMIEN",
        "authorized_official_middle_name": "EDWARD",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "843-586-0108",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PH.D., LPC, CAC-II,"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "SC",
            "license": "1411038",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Counselor, Mental Health",
            "state": "SC",
            "license": "5249",
            "primary": false
        },
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "SC",
            "license": "5249",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Community/Behavioral Health Agency in Clio, SC
• Providers in Clio, 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 Jan 29, 2016; 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.