NPIMap

Organization Active NPI

Charleston Counseling Center PC

Doing business as Lifestance Health

  • Mental Health Counselor
  • Mount Pleasant, SC
National Provider Identifier
1316375678
Registry record updated Oct 5, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
Legal business name
CHARLESTON COUNSELING CENTER PC
Doing business as
Lifestance Health
Practice address
871 Lowcountry Blvd Ste 200
Mount Pleasant, SC 29464
Phone
(843) 501-1099
NPI assigned
Oct 24, 2013
Last updated
Oct 5, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 5, 2023

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

Authorized official

Name
Ryan Pardo
Title
Chief Legal Officer
Phone
(425) 279-8500

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Clinic/Center (Including Community Mental Health Center) 261QM0801X NU
Mental Health Counselor 101YM0800X NU Primary
Professional Counselor 101YP2500X NU
Clinical Social Worker 1041C0700X 8539 SC

Addresses

Primary practice location

871 Lowcountry Blvd Ste 200
Mount Pleasant, SC 29464

Mailing address

871 Lowcountry Blvd Ste 200
Mount Pleasant, SC 29464-3096
Phone (843) 501-1099

Other names 1

  • Lifestance Health Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SC

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20160517000323 SC Part B Supplier - Clinic/Group Practice 6204125107 Receives reassigned benefits from 267 practitioners
Practice locations: Summerville, SC; Columbia, SC; Rock Hill, SC; North Charleston, SC; Myrtle Beach, SC; Mount Pleasant, SC; Goose Creek, SC; Greenville, SC…

National Provider Directory

National Provider Directory
Tax ID family
Charleston Counseling Center PC2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Member organizations 1

Organizations listed as members of this organization in the National Provider Directory.

Locations

440 Knox Abbott Dr
Ste 425
Cayce, SC 29033

1422 Ashley River Rd
Charleston, SC 29407
Phone (253) 346-0137

115 Atrium Way
Ste 221
Columbia, SC 29223
Phone (803) 699-8887

2000 Center Point Rd
Ste 2350
Columbia, SC 29210
Phone (803) 669-8887

3600 Forest Dr
Ste 302
Columbia, SC 29204
Phone (803) 699-8887

597 Old Mount Holly Rd
Ste 300
Goose Creek, SC 29445
Phone (855) 900-7318

30 Patewood Dr
Ste 160
Greenville, SC 29615
Phone (864) 455-5777

871 Lowcountry Blvd
Ste 200
Mt Pleasant, SC 29464
Phone (253) 346-0137

4000 Faber Place Dr
Ste 110
North Charleston, SC 29405
Phone (854) 246-1100

502 Cherry Rd
Rock Hill, SC 29732
Phone (839) 213-6425

314 W 4th North St
Summerville, SC 29483
Phone (631) 942-8629

651 Scholar Way
Ste 101
Summerville, SC 29486
Phone (630) 884-9012

Practitioners & affiliated clinicians

Practitioners 311

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 311

NPI Registry JSON

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

{
    "created_epoch": "1382572800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1696464000000",
    "number": "1316375678",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "871 LOWCOUNTRY BLVD STE 200",
            "city": "MOUNT PLEASANT",
            "state": "SC",
            "postal_code": "294643096",
            "telephone_number": "843-501-1099"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "871 LOWCOUNTRY BLVD STE 200",
            "city": "MOUNT PLEASANT",
            "state": "SC",
            "postal_code": "29464",
            "telephone_number": "843-501-1099"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHARLESTON COUNSELING CENTER PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-10-24",
        "last_updated": "2023-10-05",
        "certification_date": "2023-10-05",
        "status": "A",
        "authorized_official_last_name": "PARDO",
        "authorized_official_first_name": "RYAN",
        "authorized_official_title_or_position": "CHIEF LEGAL OFFICER",
        "authorized_official_telephone_number": "425-279-8500"
    },
    "taxonomies": [
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "SC",
            "license": "8539",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Lifestance Health",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Mount Pleasant, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 5, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.