Corazon of South Carolina, LLC

Primary specialty

Adolescent and Children Mental Health Clinic/CenterTaxonomy code 261QM0855X

Legal business name

CORAZON OF SOUTH CAROLINA, LLC

Practice address

1631 Main St FL 2
Columbia, SC 29201-2817

Phone

(803) 567-1217

NPI assigned

Aug 25, 2021

Organization subpart

No

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

Authorized official

Name

Kimberly Kocak, LISW-CPNPI 1598240053

Title

Owner

Phone

(614) 551-5760

Specialties & licenses 1

Addresses

Other names 2

• Corazon Holistic Health Doing business as
• Corazon of Columbia Doing business as

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Kimberly Kocak, MSW

  • Clinical Social Worker
  • Columbia, SC
  • NPI 1598240053
  NPD Authorized official

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

{
    "created_epoch": "1629849600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1757548800000",
    "number": "1326715541",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1631 MAIN ST FL 2",
            "city": "COLUMBIA",
            "state": "SC",
            "postal_code": "292012817",
            "telephone_number": "803-567-1217"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1631 MAIN ST FL 2",
            "city": "COLUMBIA",
            "state": "SC",
            "postal_code": "292012817",
            "telephone_number": "803-567-1217"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CORAZON OF SOUTH CAROLINA, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-08-25",
        "last_updated": "2025-09-11",
        "certification_date": "2021-08-25",
        "status": "A",
        "authorized_official_last_name": "KOCAK",
        "authorized_official_first_name": "KIMBERLY",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "614-551-5760",
        "authorized_official_credential": "LISW-CP"
    },
    "taxonomies": [
        {
            "code": "261QM0855X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adolescent and Children Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Corazon Holistic Health",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Corazon of Columbia",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Ramona Boulward Copeland, R.N.
• Shamyra Copeland
• Jennifer Lynn Copen, MSP, CCC-SLP
• Coram Healthcare/Carolina Home Therapeutics
• Kris Scott Coram
• Carolyn Chew Corbett, MSW MASTERS IN SOCIA
• Elizabeth Ann Corbett, LISW-CP
• Lisa Michelle Corbett, LISW-CP
• Mindy Corbett
• Suzanne Elizabeth Corbett, PTA

• Adolescent and Children Mental Health Clinic/Center in Columbia, SC
• Providers in Columbia, SC by specialty
• Adolescent and Children Mental Health Clinic/Center in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2025; 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.