Active NPI
James Furtick Jr., PH.D
- Professional Counselor
- Orangeburg, SC
National Provider Identifier
1265441265
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- 4068
- Practice address
- 108 Stage Coach Lane
Village Park
Orangeburg, SC 29118-2499 - Phone
- (803) 516-0200
- Fax
- (803) 516-8288
- NPI assigned
- Aug 7, 2006
- Last updated
- Mar 24, 2023
- Sex
- Male
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | 4068 | SC | Primary |
Addresses
Primary practice location
108 Stage Coach Lane
Village Park
Orangeburg, SC 29118-2499
Mailing address
108 Stage Coach Lane
Village Park
Orangeburg, SC 29118-2499
Phone (803) 516-0200
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| SW1049 | Medicaid | SC |
Other names 1
- Dr. Jim Furtick Jr.
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)
- Enrolled
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 4068 | SC | MD | Pediatric Occupational Therapist |
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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
- Clinical Social Worker
- Orangeburg, SC
- NPI 1518023076
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1154908800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1679616000000",
"number": "1265441265",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "108 STAGE COACH LANE",
"address_2": "VILLAGE PARK",
"city": "ORANGEBURG",
"state": "SC",
"postal_code": "291182499",
"telephone_number": "803-516-0200",
"fax_number": "803-516-8288"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "108 STAGE COACH LANE",
"address_2": "VILLAGE PARK",
"city": "ORANGEBURG",
"state": "SC",
"postal_code": "291182499",
"telephone_number": "803-516-0200",
"fax_number": "803-516-8288"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FURTICK",
"first_name": "JAMES",
"name_prefix": "Dr.",
"name_suffix": "Jr.",
"credential": "PH.D",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-08-07",
"last_updated": "2023-03-24",
"certification_date": "2023-03-24",
"status": "A"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "SC",
"license": "4068",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "SW1049",
"state": "SC"
}
],
"endpoints": [],
"other_names": [
{
"first_name": "JIM",
"last_name": "FURTICK",
"prefix": "DR.",
"suffix": "JR.",
"credential": "PH.D",
"code": "5",
"type": "Other Name"
}
]
}Other providers in Orangeburg, SC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 24, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.