Mynd Health LLC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

LCSW11977 Issued in SC

Legal business name

MYND HEALTH LLC

Practice address

1012 16TH Ave NW Ste 127
Surfside Beach, SC 29575-5285

Phone

(843) 839-2140

Fax

(843) 443-4229

NPI assigned

Nov 21, 2017

Organization subpart

No

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

Authorized official

Name

Marcy A Cates, LCSWNPI 1033259718

Title

Owner

Phone

(843) 839-2140

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in SC

Enrollment records 1

Locations

Practitioners 2

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

• Marcy Ann Cates, LCSW

  • Clinical Social Worker
  • Myrtle Beach, SC
  • NPI 1033259718
  Medicare reassignment NPD Authorized official
• Raymond Dean Paxton, LCSW

  • Clinical Social Worker
  • Poplar Bluff, MO
  • NPI 1386685659
  NPD (past)

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

{
    "created_epoch": "1511222400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1511222400000",
    "number": "1245744671",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2881",
            "city": "MURRELLS INLET",
            "state": "SC",
            "postal_code": "295762665",
            "telephone_number": "843-839-2140",
            "fax_number": "843-443-4229"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1012 16TH AVE NW STE 127",
            "city": "SURFSIDE BEACH",
            "state": "SC",
            "postal_code": "295755285",
            "telephone_number": "843-839-2140",
            "fax_number": "843-443-4229"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MYND HEALTH LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-11-21",
        "last_updated": "2017-11-21",
        "status": "A",
        "authorized_official_last_name": "CATES",
        "authorized_official_first_name": "MARCY",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "843-839-2140",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Counselor, Professional",
            "state": "SC",
            "license": "LCSW11977",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Daniel Walter Miller III, DMD
• James Grady Mills
• Daxton K. Moss, AU.D., CCC-A
• Heather Ann Moyer
• Dan Muntean, MD
• Myrtle Mental Health LLC
• Kaitlyn O'Neill, PHARMD
• Melanie Harpe O'Tuel, RN
• Julie Obenchain
• Ocean Lakes Pharmacy Inc

• Professional Counselor in Surfside Beach, SC
• Providers in Surfside Beach, SC by specialty
• Professional Counselor in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 21, 2017; 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.