Active NPI
Sara Sports Culclasure, CLINICAL COUNSELOR
- Counselor
- Dillon, SC
National Provider Identifier
1194083329
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Counselor
- Practice address
- 1324 Commerce Dr.
Dillon, SC 29536 - Phone
- (843) 774-3351
- Fax
- (843) 774-2622
- NPI assigned
- Apr 25, 2012
- Last updated
- Apr 25, 2012
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Counselor | 101Y00000X | NU | Primary |
Addresses
Primary practice location
1324 Commerce Dr.
Dillon, SC 29536
Mailing address
P.O. Box 918
1035 Cheraw St.
Bennettsville, SC 29512
Phone (843) 454-0841
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 405127 | Medicaid | SC |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| South Carolina Dept of Mental Health Accounting Office | Past | Accepting new patients | |
| South Carolina Dept of Mental Health Accounting Office | Past | Accepting new patients |
Organizations & group practices 2
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
dba Midlands Crisis Stabilization Center
- Community/Behavioral Health Agency
- Columbia, SC
- NPI 1083421994
-
dba Tricounty Community Mental Health Center
- Mental Health Clinic/Center (Including Community Mental Health Center)
- Bennetsville, SC
- NPI 1609979640
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1335312000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1335312000000",
"number": "1194083329",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "P.O. BOX 918",
"address_2": "1035 CHERAW ST.",
"city": "BENNETTSVILLE",
"state": "SC",
"postal_code": "29512",
"telephone_number": "843-454-0841",
"fax_number": "843-454-0635"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1324 COMMERCE DR.",
"city": "DILLON",
"state": "SC",
"postal_code": "29536",
"telephone_number": "843-774-3351",
"fax_number": "843-774-2622"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CULCLASURE",
"first_name": "SARA",
"middle_name": "SPORTS",
"credential": "CLINICAL COUNSELOR",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2012-04-25",
"last_updated": "2012-04-25",
"status": "A"
},
"taxonomies": [
{
"code": "101Y00000X",
"taxonomy_group": "",
"desc": "Counselor",
"state": "NU",
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "405127",
"state": "SC"
}
],
"endpoints": [],
"other_names": []
}Other providers in Dillon, SC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 25, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.