Mary L. Shults, LISW

Primary specialty

CounselorTaxonomy code 101Y00000X

License

1451 Issued in SC

Practice address

2094 Woodruff Rd
Greenville, SC 29607-5939

Phone

(864) 676-9211

Fax

(864) 676-9432

NPI assigned

Jun 2, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• Psychiatric Associates PA

  • Clinical Social Worker
  • Greenville, SC
  • NPI 1194868794
  NPD (past)

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

{
    "created_epoch": "1149206400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1192060800000",
    "number": "1306884630",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2094 WOODRUFF RD",
            "city": "GREENVILLE",
            "state": "SC",
            "postal_code": "296075939",
            "telephone_number": "864-676-9211",
            "fax_number": "864-676-9432"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2094 WOODRUFF RD",
            "city": "GREENVILLE",
            "state": "SC",
            "postal_code": "296075939",
            "telephone_number": "864-676-9211",
            "fax_number": "864-676-9432"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHULTS",
        "first_name": "MARY",
        "middle_name": "L.",
        "credential": "LISW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-02",
        "last_updated": "2007-10-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "SC",
            "license": "1451",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "SC LIC #",
            "identifier": "1451",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Shriners Hospitals for Children
• Darshan Shroff, MD
• Barbara Darlee Shrum, LPN II
• Darby Shuler
• Marshall Jasper Shuler, M.D.
• Heather Shures, LPC
• Blake D Shusterman, MD
• Kelly Nicole Shymkiw, MD
• A. Thomas Siachos, M.D.
• Christopher Nicholas Siachos, DMD

• Counselor in Greenville, SC
• Providers in Greenville, SC by specialty
• Counselor in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 11, 2007; 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.