Active NPI
Kershaw County School District
- School Counselor
- Camden, SC
National Provider Identifier
1245631167
On this page
Key facts
NPPES NPI Registry- Primary specialty
- School Counselor
- Legal business name
- KERSHAW COUNTY SCHOOL DISTRICT
- Practice address
- 1109 Campbell St
Camden, SC 29020-3507 - Phone
- (803) 425-7712
- Fax
- (803) 425-7713
- NPI assigned
- Sep 10, 2014
- Last updated
- Sep 10, 2014
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Dr. Alisa Goodman, PH.D
- Title
- Director for Instructional Support
- Phone
- (803) 432-8416
Specialties & licenses 8
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | NU | ||
| Professional Counselor | 101YP2500X | NU | ||
| School Counselor | 101YS0200X | NU | Primary | |
| Psychologist | 103T00000X | 422 | SC | |
| Clinical Psychologist | 103TC0700X | NU | ||
| Counseling Psychologist | 103TC1900X | 422 | SC | |
| School Psychologist | 103TS0200X | 422 | SC | |
| School Social Worker | 1041S0200X | NU |
Addresses
Primary practice location
1109 Campbell St
Camden, SC 29020-3507
Mailing address
2029 W Dekalb St
Camden, SC 29020-2093
Phone (803) 432-8416
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 2800 | Medicaid | SC |
Other names 1
- Kershaw County Schools RBHS
National Provider Directory
National Provider Directory- Tax ID family
- Kershaw County School District
Other organizations with this tax ID 1
Organizations that report the same tax identification number in the National Provider Directory.
-
- Local Education Agency (LEA)
- Camden, SC
- NPI 1861426074
Locations
1109 Campbell St
Camden, SC 29020
Phone (803) 425-7712
Practitioners & affiliated clinicians
Practitioners 6
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.
-
- Occupational Therapist
- Columbia, SC
- NPI 1285134874
-
- Counselor
- Camden, SC
- NPI 1194470534
-
- Social Worker
- Camden, SC
- NPI 1093462228
-
- Social Worker
- Camden, SC
- NPI 1427085166
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1410307200000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1410307200000",
"number": "1245631167",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2029 W DEKALB ST",
"city": "CAMDEN",
"state": "SC",
"postal_code": "290202093",
"telephone_number": "803-432-8416",
"fax_number": "803-425-8918"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1109 CAMPBELL ST",
"city": "CAMDEN",
"state": "SC",
"postal_code": "290203507",
"telephone_number": "803-425-7712",
"fax_number": "803-425-7713"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "KERSHAW COUNTY SCHOOL DISTRICT",
"organizational_subpart": "NO",
"enumeration_date": "2014-09-10",
"last_updated": "2014-09-10",
"status": "A",
"authorized_official_last_name": "GOODMAN",
"authorized_official_first_name": "ALISA",
"authorized_official_title_or_position": "DIRECTOR FOR INSTRUCTIONAL SUPPORT",
"authorized_official_telephone_number": "803-432-8416",
"authorized_official_name_prefix": "Dr.",
"authorized_official_credential": "PH.D"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "NU",
"license": null,
"primary": false
},
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "NU",
"license": null,
"primary": false
},
{
"code": "101YS0200X",
"taxonomy_group": "",
"desc": "Counselor, School",
"state": "NU",
"license": null,
"primary": true
},
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": "SC",
"license": "422",
"primary": false
},
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "NU",
"license": null,
"primary": false
},
{
"code": "103TC1900X",
"taxonomy_group": "",
"desc": "Psychologist, Counseling",
"state": "SC",
"license": "422",
"primary": false
},
{
"code": "103TS0200X",
"taxonomy_group": "",
"desc": "Psychologist, School",
"state": "SC",
"license": "422",
"primary": false
},
{
"code": "1041S0200X",
"taxonomy_group": "",
"desc": "Social Worker, School",
"state": "NU",
"license": null,
"primary": false
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "2800",
"state": "SC"
}
],
"endpoints": [],
"other_names": [
{
"organization_name": "Kershaw County Schools RBHS",
"code": "5",
"type": "Other Name"
}
]
}Other providers in Camden, SC
- Kershaw Cnty Psych LLC
- Kershaw County Adult Day Care Center
- Kershaw County Board of Disabilities and Special Needs
- Kershaw County Commission on Alcohol and Drug Abuse
- Kershaw County Commission on Alcohol and Drug Abuse (ALPHA Behavioral Health Center)
- Kershaw County School District
- Kershaw County Teen Health Promotion Coalition
- Kershaw Health (Kershawhealth Pathology)
- Kershaw Hospital LLC
- Kershaw Hospital LLC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 10, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.