NPIMap

Organization Active NPI

Professional Intensive Outpatient Program of Florence

  • Professional Counselor
  • Florence, SC
National Provider Identifier
1184765653
Registry record updated Jun 27, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
326 Issued in SC
Legal business name
PROFESSIONAL INTENSIVE OUTPATIENT PROGRAM OF FLORENCE
Practice address
323 S McQueen St
Florence, SC 29501-4722
Phone
(843) 673-0054
Fax
(843) 667-1549
NPI assigned
Feb 9, 2007
Last updated
Jun 27, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 27, 2008

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

Authorized official

Name
Mr. John Gary Martin, M.ED, LPC, LPCSNPI 1932361318
Title
Licensed Professional Counselor
Phone
(843) 673-0054

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Professional CounselorGroup: 193200000X MULTI-SPECIALTY GROUP 101YP2500X 326 SC Primary

Addresses

Primary practice location

323 S McQueen St
Florence, SC 29501-4722

Mailing address

323 S McQueen St
Florence, SC 29501-4722
Phone (843) 673-0054

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

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.

NPI Registry JSON

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

{
    "created_epoch": "1170979200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1214524800000",
    "number": "1184765653",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "323 S MCQUEEN ST",
            "city": "FLORENCE",
            "state": "SC",
            "postal_code": "295014722",
            "telephone_number": "843-673-0054",
            "fax_number": "843-667-1549"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "323 S MCQUEEN ST",
            "city": "FLORENCE",
            "state": "SC",
            "postal_code": "295014722",
            "telephone_number": "843-673-0054",
            "fax_number": "843-667-1549"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PROFESSIONAL INTENSIVE OUTPATIENT PROGRAM OF FLORENCE",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-09",
        "last_updated": "2008-06-27",
        "status": "A",
        "authorized_official_last_name": "MARTIN",
        "authorized_official_first_name": "JOHN",
        "authorized_official_middle_name": "GARY",
        "authorized_official_title_or_position": "LICENSED PROFESSIONAL COUNSELOR",
        "authorized_official_telephone_number": "843-673-0054",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "M.ED, LPC, LPCS"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Professional",
            "state": "SC",
            "license": "326",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Florence, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 27, 2008; 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.