NPIMap

Organization Active NPI

Family Stabilizations LLC

  • Clinical Child & Adolescent Psychologist
  • Sumter, SC
National Provider Identifier
1235219841
Registry record updated Aug 22, 2020
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Key facts

NPPES NPI Registry
Primary specialty
Clinical Child & Adolescent PsychologistTaxonomy code 103TC2200X
License
1040 Issued in SC
Legal business name
FAMILY STABILIZATIONS LLC
Practice address
504 Miller Rd
Sumter, SC 29150-3366
Phone
(803) 467-1263
Fax
(803) 234-6434
NPI assigned
Oct 17, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Mr. Gerod Gore, MSSA, LBSW
Title
Executive Director
Phone
(803) 467-1263

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Child & Adolescent PsychologistGroup: 193200000X MULTI-SPECIALTY GROUP 103TC2200X 1040 SC Primary

Addresses

Primary practice location

504 Miller Rd
Sumter, SC 29150-3366

Mailing address

PO Box 7357
Sumter, SC 29150
Phone (803) 467-1263

National Provider Directory

National Provider Directory

Locations

504 Miller Rd
Sumter, SC 29150
Phone (803) 467-1263

NPI Registry JSON

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

{
    "created_epoch": "1161043200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1235219841",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 7357",
            "city": "SUMTER",
            "state": "SC",
            "postal_code": "29150",
            "telephone_number": "803-467-1263",
            "fax_number": "803-234-6434"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "504 MILLER RD",
            "city": "SUMTER",
            "state": "SC",
            "postal_code": "291503366",
            "telephone_number": "803-467-1263",
            "fax_number": "803-234-6434"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FAMILY STABILIZATIONS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-17",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "GORE",
        "authorized_official_first_name": "GEROD",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "803-467-1263",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "MSSA, LBSW"
    },
    "taxonomies": [
        {
            "code": "103TC2200X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist, Clinical Child & Adolescent",
            "state": "SC",
            "license": "1040",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sumter, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.