Wilderness Way Camp School Inc

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

Legal business name

WILDERNESS WAY CAMP SCHOOL INC

Practice address

175 Camp School LN
Fair Play, SC 29643

Phone

(864) 972-0611

Fax

(864) 972-2045

NPI assigned

Jun 21, 2006

Last updated

Aug 22, 2020By 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

Mr. Ken R Edgar

Title

Executive Director

Phone

(864) 972-0611

Specialties & licenses 1

Addresses

Other names 1

• Wilderness Way Girls Camp Other name

Locations

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

{
    "created_epoch": "1150848000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1245276906",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "175 CAMP SCHOOL LN",
            "city": "FAIR PLAY",
            "state": "SC",
            "postal_code": "29643",
            "telephone_number": "864-972-0611",
            "fax_number": "864-972-2045"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "175 CAMP SCHOOL LN",
            "city": "FAIR PLAY",
            "state": "SC",
            "postal_code": "29643",
            "telephone_number": "864-972-0611",
            "fax_number": "864-972-2045"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WILDERNESS WAY CAMP SCHOOL INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-21",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "EDGAR",
        "authorized_official_first_name": "KEN",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "864-972-0611",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Wilderness Way Girls Camp",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

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• Mental Health Counselor in Fair Play, SC
• Providers in Fair Play, SC by specialty
• Mental Health Counselor in South Carolina

• 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.