NPIMap

Organization Active NPI

Seasons Psychological Associates, LLC

  • Clinical Psychologist
  • Florence, SC
National Provider Identifier
1376772335
Registry record updated Apr 23, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
1122 Issued in SC
Legal business name
SEASONS PSYCHOLOGICAL ASSOCIATES, LLC
Practice address
314 S McQueen St
Florence, SC 29501-4723
Phone
(843) 407-4440
Fax
(843) 407-4461
NPI assigned
Jul 10, 2009
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 23, 2015

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

Authorized official

Name
Dr. Andrea Lea Pritchard-Boone, PHDNPI 1457580896
Title
President
Phone
(843) 407-4440

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical PsychologistGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 103TC0700X 1122 SC Primary
Clinical Child & Adolescent PsychologistGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 103TC2200X 1122 SC

Addresses

Primary practice location

314 S McQueen St
Florence, SC 29501-4723

Mailing address

314 S McQueen St
Florence, SC 29501-4723
Phone (843) 407-4440

Other identifiers 1

IdentifierTypeStateIssuer
GP5420MedicaidSC

Other names 1

  • Andrea Lea Pritchard-Boone, Ph. D. Former legal business name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SC

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20110513000306 SC Part B Supplier - Clinic/Group Practice 1850577545 Receives reassigned benefits from 3 practitioners
Practice locations: Florence, SC

National Provider Directory

National Provider Directory

Locations

314 S McQueen St
Florence, SC 29501
Phone (843) 407-4440

Practitioners & affiliated clinicians

Practitioners 3

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

NPI Registry JSON

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

{
    "created_epoch": "1247184000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1429747200000",
    "number": "1376772335",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "314 S MCQUEEN ST",
            "city": "FLORENCE",
            "state": "SC",
            "postal_code": "295014723",
            "telephone_number": "843-407-4440",
            "fax_number": "843-407-4461"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "314 S MCQUEEN ST",
            "city": "FLORENCE",
            "state": "SC",
            "postal_code": "295014723",
            "telephone_number": "843-407-4440",
            "fax_number": "843-407-4461"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SEASONS PSYCHOLOGICAL ASSOCIATES, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-07-10",
        "last_updated": "2015-04-23",
        "status": "A",
        "authorized_official_last_name": "PRITCHARD-BOONE",
        "authorized_official_first_name": "ANDREA",
        "authorized_official_middle_name": "LEA",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "843-407-4440",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PHD"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Psychologist, Clinical",
            "state": "SC",
            "license": "1122",
            "primary": true
        },
        {
            "code": "103TC2200X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Psychologist, Clinical Child & Adolescent",
            "state": "SC",
            "license": "1122",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "GP5420",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Andrea Lea Pritchard-Boone, Ph. D.",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

Other providers in Florence, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 23, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.