Individual provider Active NPI

Nelzarie I Wynn

  • Professional Counselor
  • Greenville, SC
National Provider Identifier
1316591498
Registry record updated Aug 19, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
Practice address
151 Commons Way
Greenville, SC 29611-3850
Phone
(864) 908-5292
NPI assigned
Jul 28, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 19, 2019

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

Specialties & licenses 11

Specialty (taxonomy)CodeLicenseStatePrimary
Counselor 101Y00000X
Behavior Analyst 103K00000X
Addiction (Substance Use Disorder) Counselor 101YA0400X
Mental Health Counselor 101YM0800X
School Counselor 101YS0200X
Psychoanalyst 102L00000X
Psychologist 103T00000X
Addiction (Substance Use Disorder) Psychologist 103TA0400X
Family Psychologist 103TF0000X
Marriage & Family Therapist 106H00000X
Professional Counselor 101YP2500X Primary

Addresses

Primary practice location

151 Commons Way
Greenville, SC 29611-3850

Mailing address

151 Commons Way
Greenville, SC 29611-3850
Phone (864) 908-5292

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

Practice roles

OrganizationSpecialtyStatusNew patients
Universal Supportive Sevices LLC Counselor CurrentSince Aug 25, 2019 Accepting new patients

Locations

151 Commons Way
Greenville, SC 29611
Phone (864) 252-4835

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": "1564272000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1566172800000",
    "number": "1316591498",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "151 COMMONS WAY",
            "city": "GREENVILLE",
            "state": "SC",
            "postal_code": "296113850",
            "telephone_number": "864-908-5292"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "151 COMMONS WAY",
            "city": "GREENVILLE",
            "state": "SC",
            "postal_code": "296113850",
            "telephone_number": "864-908-5292"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WYNN",
        "first_name": "NELZARIE",
        "middle_name": "I",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-07-28",
        "last_updated": "2019-08-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YS0200X",
            "taxonomy_group": "",
            "desc": "Counselor, School",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "102L00000X",
            "taxonomy_group": "",
            "desc": "Psychoanalyst",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "103TA0400X",
            "taxonomy_group": "",
            "desc": "Psychologist, Addiction (Substance Use Disorder)",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "103TF0000X",
            "taxonomy_group": "",
            "desc": "Psychologist, Family",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Greenville, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 19, 2019; 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.