Channel the Beacon

Primary specialty

Case Management AgencyTaxonomy code 251B00000X

Legal business name

CHANNEL THE BEACON

Practice address

6650 Rivers Ave
Suite 1408
North Charleston, SC 29406-4809

Phone

(843) 576-1408

Fax

(843) 278-9275

NPI assigned

Aug 26, 2013

Last updated

Sep 5, 2014By 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

Johnette S Simmons, BS, MBA, DHA

Title

Executive Director

Phone

(843) 330-1522

Specialties & licenses 2

Addresses

Other identifiers 1

Locations

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

{
    "created_epoch": "1377475200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1409875200000",
    "number": "1205260304",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 41294",
            "city": "NORTH CHARLESTON",
            "state": "SC",
            "postal_code": "294231294",
            "telephone_number": "843-330-1522",
            "fax_number": "843-278-9275"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6650 RIVERS AVE",
            "address_2": "SUITE 1408",
            "city": "NORTH CHARLESTON",
            "state": "SC",
            "postal_code": "294064809",
            "telephone_number": "843-576-1408",
            "fax_number": "843-278-9275"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHANNEL THE BEACON",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-08-26",
        "last_updated": "2014-09-05",
        "status": "A",
        "authorized_official_last_name": "SIMMONS",
        "authorized_official_first_name": "JOHNETTE",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "843-330-1522",
        "authorized_official_credential": "BS, MBA, DHA"
    },
    "taxonomies": [
        {
            "code": "251B00000X",
            "taxonomy_group": "",
            "desc": "Case Management",
            "state": "SC",
            "license": null,
            "primary": true
        },
        {
            "code": "251V00000X",
            "taxonomy_group": "",
            "desc": "Voluntary or Charitable",
            "state": "SC",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "CM1007",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Changes Counseling Center, LLC
• Demario Andres Chappell
• Charleston Addiction Medicine, LLC
• Charleston Birth Place, Inc
• Charleston Bracing, LLC
• Charleston Cancer Center PA

• Case Management Agency in North Charleston, SC
• Providers in North Charleston, SC by specialty
• Case Management Agency in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 5, 2014; 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.