Dwayne St. Thomas, MED

Primary specialty

CounselorTaxonomy code 101Y00000X

Practice address

2100 Charlie Hall Blvd
Charleston, SC 29414-5832

Phone

(843) 852-4100

NPI assigned

Apr 9, 2009

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Education

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

{
    "created_epoch": "1239235200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1628121600000",
    "number": "1457594285",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4760 SEPULVEDA BLVD",
            "city": "CULVER CITY",
            "state": "CA",
            "postal_code": "90230",
            "telephone_number": "310-390-6612",
            "fax_number": "310-398-5690"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2100 CHARLIE HALL BLVD",
            "city": "CHARLESTON",
            "state": "SC",
            "postal_code": "294145832",
            "telephone_number": "843-852-4100"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1007 Myrtle Ave",
            "address_purpose": "LOCATION",
            "city": "Inglewood",
            "state": "CA",
            "postal_code": "903014009",
            "country_code": "US",
            "telephone_number": "310-412-4191",
            "fax_number": "310-412-3942",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ST. THOMAS",
        "first_name": "DWAYNE",
        "name_prefix": "Mr.",
        "credential": "MED",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2009-04-09",
        "last_updated": "2021-08-05",
        "certification_date": "2021-08-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1760596480",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Counselor in Charleston, SC
• Providers in Charleston, SC by specialty
• Counselor in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 5, 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.