Organization Active NPI

Sound Mind Mental Health

  • Psychiatric/Mental Health Nurse Practitioner
  • Summerville, SC
National Provider Identifier
1245046242
Registry record updated Dec 11, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
Legal business name
SOUND MIND MENTAL HEALTH
Practice address
204 N Cedar St Ste 100
Summerville, SC 29483-6453
Phone
(843) 821-2480
NPI assigned
Dec 5, 2024
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 11, 2024

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

Authorized official

Name
Norma June Taveras, PHMNP-BCNPI 1053133157
Title
Nurse Practitioner
Phone
(864) 933-4097

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse PractitionerGroup: 193400000X SINGLE SPECIALTY GROUP 363LP0808X Primary

Addresses

Primary practice location

204 N Cedar St Ste 100
Summerville, SC 29483-6453

Mailing address

231 Pavilion St
Summerville, SC 29483-8411
Phone (864) 933-4097

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SC

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20250107001582 SC Part B Supplier - Clinic/Group Practice 5799213567 Receives reassigned benefits from 1 practitioner
Practice locations: Summerville, SC

National Provider Directory

National Provider Directory

Locations

204 N Cedar St
Ste 100
Summerville, SC 29483
Phone (843) 821-2480

Practitioners & affiliated clinicians

Practitioners 1

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

NPI Registry JSON

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

{
    "created_epoch": "1733356800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1733875200000",
    "number": "1245046242",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "231 PAVILION ST",
            "city": "SUMMERVILLE",
            "state": "SC",
            "postal_code": "294838411",
            "telephone_number": "864-933-4097"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "204 N CEDAR ST STE 100",
            "city": "SUMMERVILLE",
            "state": "SC",
            "postal_code": "294836453",
            "telephone_number": "843-821-2480"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUND MIND MENTAL HEALTH",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-12-05",
        "last_updated": "2024-12-11",
        "certification_date": "2024-12-11",
        "status": "A",
        "authorized_official_last_name": "TAVERAS",
        "authorized_official_first_name": "NORMA",
        "authorized_official_middle_name": "JUNE",
        "authorized_official_title_or_position": "NURSE PRACTITIONER",
        "authorized_official_telephone_number": "864-933-4097",
        "authorized_official_credential": "PHMNP-BC"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Summerville, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 11, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.