Active NPI
Savannah Marie Wall
- Mental Health Counselor
- Greenwood, SC
National Provider Identifier
1245845486
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- Practice address
- 1547 Parkway
Greenwood, SC 29646-4081 - Phone
- (864) 229-7120
- NPI assigned
- Sep 14, 2020
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | Primary |
Addresses
Primary practice location
1547 Parkway
Greenwood, SC 29646-4081
Mailing address
1547 Parkway
Greenwood, SC 29646-4081
Phone (864) 229-7120
Other practice location 1
10320 W McDowell Rd Ste 7022
Avondale, AZ 85392-4871
Phone (623) 215-8189
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 3335 | Other | SC | MEDICARE |
| 421504 | Medicaid | SC |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| South Carolina Dept of Mental Health Accounting Office | Current | Accepting new patients |
Locations
1547 Parkway
Greenwood, SC 29646
Phone (864) 223-8331
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Mental Health Clinic/Center (Including Community Mental Health Center)
- Greenwood, SC
- NPI 1124135009
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1600041600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1624320000000",
"number": "1245845486",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1547 PARKWAY",
"city": "GREENWOOD",
"state": "SC",
"postal_code": "296464081",
"telephone_number": "864-229-7120"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1547 PARKWAY",
"city": "GREENWOOD",
"state": "SC",
"postal_code": "296464081",
"telephone_number": "864-229-7120"
}
],
"practiceLocations": [
{
"address_1": "10320 W McDowell Rd Ste 7022",
"address_purpose": "LOCATION",
"city": "Avondale",
"state": "AZ",
"postal_code": "853924871",
"country_code": "US",
"telephone_number": "623-215-8189",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "WALL",
"first_name": "SAVANNAH",
"middle_name": "MARIE",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2020-09-14",
"last_updated": "2021-06-22",
"certification_date": "2021-06-22",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICARE",
"identifier": "3335",
"state": "SC"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "421504",
"state": "SC"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Greenwood, SC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 22, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.