Organization Active NPI

Seed Harvest Time Residential Behavioral Services, LLC

  • Counselor
  • Kingstree, SC
National Provider Identifier
1376976837
Registry record updated Aug 19, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
CounselorTaxonomy code 101Y00000X
Legal business name
SEED HARVEST TIME RESIDENTIAL BEHAVIORAL SERVICES, LLC
Practice address
209 Hampton Ave
Kingstree, SC 29556-3415
Phone
(843) 401-0005
Fax
(843) 401-0006
NPI assigned
Aug 19, 2013
Last updated
Aug 19, 2013By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 19, 2013

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

Authorized official

Name
Rosalind Gamble, M.A.,PMHC
Title
Clinical Director
Phone
(843) 319-7843

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
CounselorGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 101Y00000X Primary

Addresses

Primary practice location

209 Hampton Ave
Kingstree, SC 29556-3415

Mailing address

444 Manning Hwy
Greeleyville, SC 29056-9299
Phone (843) 319-7843

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20210209001577 SC Part B Supplier - Mass Immunization (Roster Biller Only) 6406261254 Practice locations: Greeleyville, SC

National Provider Directory

National Provider Directory
Tax ID family
Seed Harvest Time Residential Behavioral Services LLC2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Locations

209 Hampton Ave
Kingstree, SC 29556
Phone (843) 401-0005

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1376870400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1376870400000",
    "number": "1376976837",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "444 MANNING HWY",
            "city": "GREELEYVILLE",
            "state": "SC",
            "postal_code": "290569299",
            "telephone_number": "843-319-7843",
            "fax_number": "843-401-0006"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "209 HAMPTON AVE",
            "city": "KINGSTREE",
            "state": "SC",
            "postal_code": "295563415",
            "telephone_number": "843-401-0005",
            "fax_number": "843-401-0006"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SEED HARVEST TIME RESIDENTIAL BEHAVIORAL SERVICES, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-08-19",
        "last_updated": "2013-08-19",
        "status": "A",
        "authorized_official_last_name": "GAMBLE",
        "authorized_official_first_name": "ROSALIND",
        "authorized_official_title_or_position": "CLINICAL DIRECTOR",
        "authorized_official_telephone_number": "843-319-7843",
        "authorized_official_credential": "M.A.,PMHC"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Counselor",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kingstree, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 19, 2013; 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.