Faith & Fly Psychiatric Practice, LLC

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

Legal business name

FAITH & FLY PSYCHIATRIC PRACTICE, LLC

Practice address

2424 India Hook Rd
Rock Hill, SC 29732-2784

Phone

(803) 801-0878

NPI assigned

Mar 24, 2021

Organization subpart

No

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

Authorized official

Name

Mary Goldin

Title

Pmhnp-BC

Phone

(803) 801-0878

Specialties & licenses 1

Addresses

Other identifiers 2

Electronic endpoints 1

Locations

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

{
    "created_epoch": "1616544000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1616544000000",
    "number": "1467038828",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3326 JACKSON CREEK RD",
            "city": "WINNSBORO",
            "state": "SC",
            "postal_code": "291806600"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2424 INDIA HOOK RD",
            "city": "ROCK HILL",
            "state": "SC",
            "postal_code": "297322784",
            "telephone_number": "803-801-0878"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3326 Jackson Creek Rd",
            "address_purpose": "LOCATION",
            "city": "Winnsboro",
            "state": "SC",
            "postal_code": "291806600",
            "country_code": "US",
            "telephone_number": "803-801-0878",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "FAITH & FLY PSYCHIATRIC PRACTICE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-03-24",
        "last_updated": "2021-03-24",
        "certification_date": "2021-03-24",
        "status": "A",
        "authorized_official_last_name": "GOLDIN",
        "authorized_official_first_name": "MARY",
        "authorized_official_title_or_position": "PMHNP-BC",
        "authorized_official_telephone_number": "803-801-0878"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PTAN",
            "identifier": "B919",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "GP6088",
            "state": "SC"
        }
    ],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "8038870878",
            "affiliation": "N",
            "endpointDescription": "FAX",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "address_1": "3326 Jackson Creek Rd",
            "city": "Winnsboro",
            "state": "SC",
            "country_code": "US",
            "postal_code": "291806600",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Ashton Fabian, M.S. CCC-SLP
• Donna Lynn Faile, LPC
• Reagan E Faile, PHARMD
• Spencer Reid Fair, DMD
• Hannah Fairfax
• Faith & Love Services LLC
• Ryan Christopher Faker, PT
• Andrew Falkovsky, DMD
• Klaudia Falkovsky, DMD
• Philip Neil Falls

• Psychiatry Physician in Rock Hill, SC
• Providers in Rock Hill, SC by specialty
• Psychiatry Physician in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 24, 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.