Prezillic Daniels, MA, LPC/I

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

4982 Issued in SC

Practice address

1803 Cherokee Rd
Florence, SC 29501-4184

Phone

(843) 661-6030

Fax

(843) 679-2633

NPI assigned

Jun 19, 2012

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in SC

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Mental Health Counselor

Education

Other, 2008

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Wellspring Psychology Group LLCGroup PAC ID 9537382692, 13 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Arts

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Wellspring Psychology Group LLC

  • Clinical Psychologist
  • Florence, SC
  • NPI 1255756565
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1340064000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1340064000000",
    "number": "1467715136",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1803 CHEROKEE RD",
            "city": "FLORENCE",
            "state": "SC",
            "postal_code": "295014184",
            "telephone_number": "843-661-6030",
            "fax_number": "843-679-2633"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1803 CHEROKEE RD",
            "city": "FLORENCE",
            "state": "SC",
            "postal_code": "295014184",
            "telephone_number": "843-661-6030",
            "fax_number": "843-679-2633"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DANIELS",
        "first_name": "PREZILLIC",
        "credential": "MA, LPC/I",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-06-19",
        "last_updated": "2012-06-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "SC",
            "license": "4982",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Dan H Allen PHD PA
• Daniel & Max, LLC
• Daniels Discovery Dynamics, LLC
• Hope Daniels
• Jasmine Daniels, ABO, LDO
• Valerie Janet Daniels, DO
• India A Dargan
• Noah Dargy, MD
• Satya Datla, M.D.
• Daughtry Orthodontics

• Professional Counselor in Florence, SC
• Providers in Florence, SC by specialty
• Professional Counselor in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 19, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.