Woodrow Anthony Roeback III, CPC, CRC, LPC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

12362 Issued in SC

Practice address

1103 48TH Ave N Ste 201
Myrtle Beach, SC 29577-5418

Phone

(843) 501-1099

Fax

(843) 405-2040

NPI assigned

Mar 1, 2013

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 5

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Mind Body and Spirit Counseling Services, LLC

  • Professional Counselor
  • Palmdale, CA
  • NPI 1194159004
  NPD Authorized official
• Charleston Counseling Center PC

  • Mental Health Counselor
  • Mount Pleasant, SC
  • NPI 1316375678
  NPD
• Myrtle Beach Counseling Center

  • Mental Health Counselor
  • Myrtle Beach, SC
  • NPI 1235784661
  NPD

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

{
    "created_epoch": "1362096000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1784764800000",
    "number": "1356681241",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1103 48TH AVE N STE 201",
            "city": "MYRTLE BEACH",
            "state": "SC",
            "postal_code": "295775418",
            "telephone_number": "843-501-1099",
            "fax_number": "843-405-2040"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1103 48TH AVE N STE 201",
            "city": "MYRTLE BEACH",
            "state": "SC",
            "postal_code": "295775418",
            "telephone_number": "843-501-1099",
            "fax_number": "843-405-2040"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "241 W Quail Dr",
            "address_purpose": "LOCATION",
            "city": "Palmdale",
            "state": "CA",
            "postal_code": "935512943",
            "country_code": "US",
            "telephone_number": "702-917-9309",
            "fax_number": "702-255-7171",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ROEBACK",
        "first_name": "WOODROW",
        "middle_name": "ANTHONY",
        "name_prefix": "Dr.",
        "name_suffix": "III",
        "credential": "CPC, CRC, LPC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2013-03-01",
        "last_updated": "2026-07-23",
        "certification_date": "2026-07-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "CA",
            "license": "9352",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NV",
            "license": "CP0182",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "SC",
            "license": "12362",
            "primary": true
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "UT",
            "license": "128746726004",
            "primary": false
        },
        {
            "code": "302F00000X",
            "taxonomy_group": "",
            "desc": "Exclusive Provider Organization",
            "state": "NV",
            "license": "NV20131237531",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAQH",
            "identifier": "15102754",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Eugene Bonnette Rodrick, MD, PHD
• Jessica Rodrigues, DDS
• Euleidys Michelle Rodriguez Rosario
• Jonathan Rodriguez, DO
• Joseph Rodriguez, DMD
• Rogers Chiropractic LLC
• Cedric Michael Rogers, PTA
• Kenneth Alexander Rogers, D.C.
• Lindsey Amanda Rogers
• Shata Rogers

• Professional Counselor in Myrtle Beach, SC
• Providers in Myrtle Beach, SC by specialty
• Professional Counselor in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 23, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.