Active NPI
Geode Health of South Carolina, LLC
- Psychiatry Physician
- Fort Mill, SC
National Provider Identifier
1295655587
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychiatry Physician
- Legal business name
- GEODE HEALTH OF SOUTH CAROLINA, LLC
- Practice address
- 111 Clebourne St Ste 310
Fort Mill, SC 29715-1758 - Phone
- (888) 902-1704
- NPI assigned
- Jul 17, 2026
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Brandy Marriner
- Title
- Credentialing Manager
- Phone
- (630) 912-4241
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychiatry Physician | 2084P0800X | Primary |
Addresses
Primary practice location
111 Clebourne St Ste 310
Fort Mill, SC 29715-1758
Mailing address
1211 W 22ND St Ste 406
Oak Brook, IL 60523-2169
Phone (888) 902-1704
National Provider Directory
National Provider DirectoryLocations
111 Clebourne St
Ste 310
Fort Mill, SC 29715
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1784246400000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1788134400000",
"number": "1295655587",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1211 W 22ND ST STE 406",
"city": "OAK BROOK",
"state": "IL",
"postal_code": "605232169",
"telephone_number": "888-902-1704"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "111 CLEBOURNE ST STE 310",
"city": "FORT MILL",
"state": "SC",
"postal_code": "297151758",
"telephone_number": "888-902-1704"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "GEODE HEALTH OF SOUTH CAROLINA, LLC",
"organizational_subpart": "NO",
"enumeration_date": "2026-07-17",
"last_updated": "2026-08-31",
"certification_date": "2026-08-31",
"status": "A",
"authorized_official_last_name": "MARRINER",
"authorized_official_first_name": "BRANDY",
"authorized_official_title_or_position": "CREDENTIALING MANAGER",
"authorized_official_telephone_number": "630-912-4241"
},
"taxonomies": [
{
"code": "2084P0800X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Psychiatry & Neurology, Psychiatry",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Fort Mill, SC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 31, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.