Individual provider Active NPI

Kimberly Lewis

  • Mental Health Counselor
  • Conway, SC
National Provider Identifier
1316448830
Registry record updated Oct 12, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
6992 Issued in SC
Practice address
2404 Wise Rd
Conway, SC 29526-5521
Phone
(843) 365-8884
NPI assigned
Feb 21, 2018
Last updated
Oct 12, 2020By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 12, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X 6992 SC Primary

Addresses

Primary practice location

2404 Wise Rd
Conway, SC 29526-5521

Mailing address

4108 Carolina Commercial Drive Suite 2
Myrtle Beach, SC 29579-4223
Phone (843) 469-1252

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
6992SCMDAnesthesiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Anchor of Hope Counseling Services LLC Mental Health CurrentSince Oct 19, 2020 Accepting new patients

Locations

4108 Carolina Commercial Dr
Unit 2
Myrtle Beach, SC 29579

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.

NPI Registry JSON

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

{
    "created_epoch": "1519171200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1602460800000",
    "number": "1316448830",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4108 CAROLINA COMMERCIAL DRIVE SUITE 2",
            "city": "MYRTLE BEACH",
            "state": "SC",
            "postal_code": "295794223",
            "telephone_number": "843-469-1252"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2404 WISE RD",
            "city": "CONWAY",
            "state": "SC",
            "postal_code": "295265521",
            "telephone_number": "843-365-8884"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEWIS",
        "first_name": "KIMBERLY",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-02-21",
        "last_updated": "2020-10-12",
        "certification_date": "2020-10-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "SC",
            "license": "6992",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Conway, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 12, 2020; 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.