NPIMap

Organization Active NPI

Divine Intervention Counseling Services

  • Community/Behavioral Health Agency
  • North Charleston, SC
National Provider Identifier
1235431784
Registry record updated Dec 3, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Behavioral Health AgencyTaxonomy code 251S00000X
License
5026 Issued in SC
Legal business name
DIVINE INTERVENTION COUNSELING SERVICES
Practice address
3236 Landmark Drive
Suite 124
North Charleston, SC 29418
Phone
(843) 642-1492
Fax
(843) 225-9124
NPI assigned
Dec 3, 2010
Last updated
Dec 3, 2010By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 3, 2010

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

Authorized official

Name
Mr. Raphael Patrick Ekong, LPCNPI 1952430514
Title
Licensed Professional Counselor
Phone
(843) 642-1492

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
Community/Behavioral Health Agency 251S00000X 5026 SC Primary

Addresses

Primary practice location

3236 Landmark Drive
Suite 124
North Charleston, SC 29418

Mailing address

3236 Landmark Drive
Suite 124
North Charleston, SC 29418
Phone (843) 642-1492

Other identifiers 1

IdentifierTypeStateIssuer
PC1071MedicaidSC

National Provider Directory

National Provider Directory

Locations

3236 Landmark Dr
Ste 124
North Charleston, SC 29418
Phone (843) 642-1492

Practitioners & affiliated clinicians

Practitioners 2

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": "1291334400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1291334400000",
    "number": "1235431784",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3236 LANDMARK DRIVE",
            "address_2": "SUITE 124",
            "city": "NORTH CHARLESTON",
            "state": "SC",
            "postal_code": "29418",
            "telephone_number": "843-642-1492",
            "fax_number": "843-225-9124"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3236 LANDMARK DRIVE",
            "address_2": "SUITE 124",
            "city": "NORTH CHARLESTON",
            "state": "SC",
            "postal_code": "29418",
            "telephone_number": "843-642-1492",
            "fax_number": "843-225-9124"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DIVINE INTERVENTION COUNSELING SERVICES",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-12-03",
        "last_updated": "2010-12-03",
        "status": "A",
        "authorized_official_last_name": "EKONG",
        "authorized_official_first_name": "RAPHAEL",
        "authorized_official_middle_name": "PATRICK",
        "authorized_official_title_or_position": "LICENSED PROFESSIONAL COUNSELOR",
        "authorized_official_telephone_number": "843-642-1492",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "LPC"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "SC",
            "license": "5026",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "PC1071",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in North Charleston, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 3, 2010; 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.