Mha

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

101YM0800X Issued in SC

Legal business name

MHA

Practice address

200 Claude Bundrick Rd
Blythewood, SC 29016-9420

Phone

(803) 786-5478

NPI assigned

Nov 20, 2009

Organization subpart

No

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

Authorized official

Name

Ms. Carlissa Y Goodwin

Title

Care Provider

Phone

(803) 735-9680

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1258675200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1258675200000",
    "number": "1285962886",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "419 TORWOOD DR",
            "city": "COLUMBIA",
            "state": "SC",
            "postal_code": "29203",
            "telephone_number": "803-714-0948"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 CLAUDE BUNDRICK RD",
            "city": "BLYTHEWOOD",
            "state": "SC",
            "postal_code": "290169420",
            "telephone_number": "803-786-5478"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MHA",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-11-20",
        "last_updated": "2009-11-20",
        "status": "A",
        "authorized_official_last_name": "GOODWIN",
        "authorized_official_first_name": "CARLISSA",
        "authorized_official_middle_name": "Y",
        "authorized_official_title_or_position": "CARE PROVIDER",
        "authorized_official_telephone_number": "803-735-9680",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Counselor, Mental Health",
            "state": "SC",
            "license": "101YM0800X",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Benjamin Mathew, PHD
• Ashley Mazzanna, CCC-SLP
• Kelsey Klostermeyer McDill, M.D.
• Christa McLaughlin, MSW
• Mental Health America
• Rutileia Da Silva Michel
• Kendra Marie Suddeth Miller, LISW-CP
• Wendy Monroe
• Andrew L. Moore, P.T.A.
• William Morrison, PT

• Mental Health Counselor in Blythewood, SC
• Providers in Blythewood, SC by specialty
• Mental Health Counselor in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 20, 2009; 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.