Individual provider Active NPI

Carolyn W Fulmore, LPC

  • Mental Health Counselor
  • Columbia, SC
National Provider Identifier
1487766549
Registry record updated May 19, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
7017 Issued in SC
Practice address
115 Atrium Way Ste 221
Columbia, SC 29223-6383
Phone
(843) 501-1099
Fax
(803) 699-8824
NPI assigned
Aug 31, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 19, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X 7017 SC Primary

Addresses

Primary practice location

115 Atrium Way Ste 221
Columbia, SC 29223-6383

Mailing address

115 Atrium Way Ste 221
Columbia, SC 29223-6383
Phone (803) 699-8887

Other practice location 1

122 Latimer St
Latta, SC 29565-1828
Phone (843) 627-6252

Other practice location 2

1430 S Cashua Dr
Florence, SC 29501-6323
Phone (843) 673-0660 ext. 228

Other identifiers 1

IdentifierTypeStateIssuer
PC2070MedicaidSC

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20240122000580 SC Practitioner - Mental Health Counselor 6507192333 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Charleston Counseling Center PCGroup PAC ID 6204125107, 186 clinicians

Practice addresses (Care Compare)

115 Atrium Way
Suite 221
Columbia, SC 29223-6383
Phone (843) 501-1099

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
7017SCMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Caresouth Carolina, Inc. Current Accepting new patients
Caresouth Carolina, Inc CurrentSince Jan 1, 2024 Accepting new patients
Wright Directions, LLC Mental Health Past Accepting new patients
Caresouth Carolina Inc Past Accepting new patients

Locations

545 Sumter Hwy
Bishopville, SC 29010
Phone (803) 484-5317

1268 S 4th St
Hartsville, SC 29550
Phone (843) 332-3422

122 Latimer St
Latta, SC 29565
Phone (843) 627-6252

737 S Main St
Society Hill, SC 29593
Phone (843) 378-3000

Organizations & group practices 5

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.

NPI Registry JSON

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

{
    "created_epoch": "1156982400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1779148800000",
    "number": "1487766549",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "115 ATRIUM WAY STE 221",
            "city": "COLUMBIA",
            "state": "SC",
            "postal_code": "292236383",
            "telephone_number": "803-699-8887",
            "fax_number": "803-699-8824"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "115 ATRIUM WAY STE 221",
            "city": "COLUMBIA",
            "state": "SC",
            "postal_code": "292236383",
            "telephone_number": "843-501-1099",
            "fax_number": "803-699-8824"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "122 Latimer St",
            "address_purpose": "LOCATION",
            "city": "Latta",
            "state": "SC",
            "postal_code": "295651828",
            "country_code": "US",
            "telephone_number": "843-627-6252",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1430 S Cashua Dr",
            "address_purpose": "LOCATION",
            "city": "Florence",
            "state": "SC",
            "postal_code": "295016323",
            "country_code": "US",
            "telephone_number": "843-673-0660 x228",
            "fax_number": "843-679-5666",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "FULMORE",
        "first_name": "CAROLYN",
        "middle_name": "W",
        "name_prefix": "Ms.",
        "credential": "LPC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-31",
        "last_updated": "2026-05-19",
        "certification_date": "2026-05-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "SC",
            "license": "7017",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "PC2070",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Columbia, SC

Sources for this page

Verify at the official NPI Registry.