Individual provider Active NPI

Debra Cole Culbertson, MED, LPC, LAC, LPCS

  • Professional Counselor
  • Seneca, SC
National Provider Identifier
1356787899
Registry record updated Dec 2, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
3474 Issued in SC
Practice address
455 Highway 123 Ste C
Seneca, SC 29678-0855
Phone
(864) 710-4723
Fax
(864) 752-1186
NPI assigned
May 10, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 2, 2021

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Counselor 101Y00000X 6903 SC
Addiction (Substance Use Disorder) Counselor 101YA0400X 669 SC
Professional Counselor 101YP2500X 3474 SC Primary

Addresses

Primary practice location

455 Highway 123 Ste C
Seneca, SC 29678-0855

Mailing address

259 Winstead Rd
West Union, SC 29696-3026
Phone (864) 710-4723

Other identifiers 1

IdentifierTypeStateIssuer
PC1794MedicaidSC

Other names 1

  • Dee Dee Culbertson Other name

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
Credentials
Master of Education

State licenses

LicenseStateTypeSpecialty
6903SCMDMental Health Counselor
3474SCMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Magnolia Family Counseling LLC Professional CurrentSince Jan 31, 2021 Accepting new patients

Locations

135 Eagles Nest Dr
Ste C
Seneca, SC 29678

455 Highway 123
Ste C
Seneca, SC 29678
Phone (864) 710-4723

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1368144000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1638403200000",
    "number": "1356787899",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "259 WINSTEAD RD",
            "city": "WEST UNION",
            "state": "SC",
            "postal_code": "296963026",
            "telephone_number": "864-710-4723",
            "fax_number": "864-752-1186"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "455 HIGHWAY 123 STE C",
            "city": "SENECA",
            "state": "SC",
            "postal_code": "296780855",
            "telephone_number": "864-710-4723",
            "fax_number": "864-752-1186"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CULBERTSON",
        "first_name": "DEBRA",
        "middle_name": "COLE",
        "credential": "MED, LPC, LAC, LPCS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-05-10",
        "last_updated": "2021-12-02",
        "certification_date": "2021-12-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "SC",
            "license": "6903",
            "primary": false
        },
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "SC",
            "license": "669",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "SC",
            "license": "3474",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "PC1794",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "DEE DEE",
            "last_name": "CULBERTSON",
            "credential": "MED, LPC, LAC, LPCS",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Seneca, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 2, 2021; 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.