Safe Space Counseling, LLC

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

Legal business name

SAFE SPACE COUNSELING, LLC

Practice address

5900 Core Rd Ste 104
North Charleston, SC 29406-6000

Phone

(843) 779-9005

NPI assigned

May 17, 2024

Last updated

May 17, 2024By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Maurice Mazyck

Title

Clinical Director

Phone

(843) 810-2797

Specialties & licenses 1

Addresses

Locations

Practitioners 1

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.

• Keristen Mazyck, LISW-CP

  • Clinical Social Worker
  • Charleston, SC
  • NPI 1710581046
  NPD

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

{
    "created_epoch": "1715904000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1715904000000",
    "number": "1457100695",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5900 CORE RD STE 1041632",
            "city": "NORTH CHARLESTON",
            "state": "SC",
            "postal_code": "294066056",
            "telephone_number": "843-779-9005"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5900 CORE RD STE 104",
            "city": "NORTH CHARLESTON",
            "state": "SC",
            "postal_code": "294066000",
            "telephone_number": "843-779-9005"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SAFE SPACE COUNSELING, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-05-17",
        "last_updated": "2024-05-17",
        "certification_date": "2024-05-17",
        "status": "A",
        "authorized_official_last_name": "MAZYCK",
        "authorized_official_first_name": "MAURICE",
        "authorized_official_title_or_position": "CLINICAL DIRECTOR",
        "authorized_official_telephone_number": "843-810-2797"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Clinical Social Worker in North Charleston, SC
• Providers in North Charleston, SC by specialty
• Clinical Social Worker in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 17, 2024; 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.