NPIMap

South Carolina Dept of Mental Health Accounting Office

Organization Active NPI Mental Health Clinic/Center (Including Community Mental Health Center) · Florence, SC

NPI 1205925567 · NPPES record last updated Sep 20, 2019

Key facts

NPI
1205925567
Entity type
Organization (NPI type 2)
Primary specialty
Mental Health Clinic/Center (Including Community Mental Health Center) 261QM0801X
Legal business name
SOUTH CAROLINA DEPT OF MENTAL HEALTH ACCOUNTING OFFICE
Practice address
125 E Cheves St
Florence, SC 29506-2526
Phone
(843) 317-4089
Fax
(843) 317-4096
NPI assigned
Oct 12, 2006
Organization subpart
Yes
Parent organization (as reported)
SOUTH CAROLINA DEPT OF MENTAL HEALTH

Authorized official

Name
Tracy L Turner
Title
Controller
Phone
(803) 898-8503

Other NPIs on the same Medicare enrollment 15

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

Corporate family (same tax ID) 24

Organizations that report the same tax identification number in the National Provider Directory.

Practitioners 12

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

Medicare participation

Medicare fee-for-service enrollment
Enrolled in SC

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
O20031107000041 SC Part B Supplier - Clinic/Group Practice 9032021175 Receives reassigned benefits from 243 practitioners
15 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: McCormick, SC; Greenwood, SC; Hartsville, SC; Lake City, SC; Lancaster, SC; Lexington, SC; Manning, SC; Marion, SC…

National Provider Directory

Tax ID family
Lexington Co Comm Men H (61 organizations share this tax ID)
Part of
Lexington Co Comm Men H

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Clinic/Center (Including Community Mental Health Center) 261QM0801X Yes

Addresses

Primary practice location

125 E Cheves St
Florence, SC 29506-2526

Mailing address

125 E Cheves St
Florence, SC 29506-2526
Phone (843) 317-4089

Other identifiers

IdentifierTypeStateIssuer
376241MedicaidSC

Other names

  • Pee Dee Mental Health Center Doing business as

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Sep 20, 2019.

{
    "created_epoch": "1160611200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1568937600000",
    "number": "1205925567",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "125 E CHEVES ST",
            "city": "FLORENCE",
            "state": "SC",
            "postal_code": "295062526",
            "telephone_number": "843-317-4089",
            "fax_number": "843-317-4096"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "125 E CHEVES ST",
            "city": "FLORENCE",
            "state": "SC",
            "postal_code": "295062526",
            "telephone_number": "843-317-4089",
            "fax_number": "843-317-4096"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTH CAROLINA DEPT OF MENTAL HEALTH ACCOUNTING OFFICE",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "SOUTH CAROLINA DEPT OF MENTAL HEALTH",
        "enumeration_date": "2006-10-12",
        "last_updated": "2019-09-20",
        "status": "A",
        "authorized_official_last_name": "TURNER",
        "authorized_official_first_name": "TRACY",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "CONTROLLER",
        "authorized_official_telephone_number": "803-898-8503"
    },
    "taxonomies": [
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "376241",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Pee Dee Mental Health Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Florence, SC

All providers in Florence, SC · Mental Health Clinic/Center (Including Community Mental Health Center) in South Carolina

Sources for this page

Verify at the official NPI Registry.