Individual provider Active NPI

Robert Michael Bain, LMFT

  • Marriage & Family Therapist
  • Spartanburg, SC
National Provider Identifier
1508413576
Registry record updated Jun 8, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
7905 Issued in SC
Practice address
460 Langdon St
Spartanburg, SC 29302-1416
Phone
(864) 582-2411
Fax
(864) 582-7178
NPI assigned
Aug 23, 2019
Last updated
Jun 8, 2023By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 8, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X
Marriage & Family Therapist 106H00000X 7905 SC Primary

Addresses

Primary practice location

460 Langdon St
Spartanburg, SC 29302-1416

Mailing address

P.O. Box 5158
Spartanburg, SC 29304-5158
Phone (864) 504-3628

Other identifiers 1

IdentifierTypeStateIssuer
LT1110MedicaidSC

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Opted out of Medicare
Yes, effective Apr 1, 2026 through Apr 1, 2028

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
7905SCMDMarriage & Family Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Regenesis Organization Community Health Center Mental Health CurrentSince Dec 11, 2023 Accepting new patients
Regenesis Organization Community Health Center CurrentSince Dec 11, 2023 Accepting new patients
Regenesis Organization Community Health Center Current Accepting new patients
Regenesis Organization Community Health Center Current Accepting new patients
Regenesis Organization Community Health Center Current Accepting new patients

Locations

460 Langdon St
Spartanburg, SC 29302
Phone (864) 582-2817

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1566518400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1686182400000",
    "number": "1508413576",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "P.O. BOX 5158",
            "city": "SPARTANBURG",
            "state": "SC",
            "postal_code": "293045158",
            "telephone_number": "864-504-3628",
            "fax_number": "864-594-0040"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "460 LANGDON ST",
            "city": "SPARTANBURG",
            "state": "SC",
            "postal_code": "293021416",
            "telephone_number": "864-582-2411",
            "fax_number": "864-582-7178"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BAIN",
        "first_name": "ROBERT",
        "middle_name": "MICHAEL",
        "credential": "LMFT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-08-23",
        "last_updated": "2023-06-08",
        "certification_date": "2023-06-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "SC",
            "license": "7905",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "LT1110",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Spartanburg, SC

Sources for this page

Verify at the official NPI Registry.