Individual provider Active NPI

Savannah Marie Wall

  • Mental Health Counselor
  • Greenwood, SC
National Provider Identifier
1245845486
Registry record updated Jun 22, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
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

Updated by the provider on Jun 22, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
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

IdentifierTypeStateIssuer
3335OtherSCMEDICARE
421504MedicaidSC

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

OrganizationSpecialtyStatusNew patients
South Carolina Dept of Mental Health Accounting Office CurrentSince Jun 27, 2021 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.

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.

Verify at the official NPI Registry.