Individual provider Active NPI

Kiavanna L Brown

  • Professional Counselor
  • Summerville, SC
National Provider Identifier
1508511809
Registry record updated Mar 17, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
10290 Issued in SC
Practice address
651 Scholar Way Ste 101
Summerville, SC 29486-3052
Phone
(843) 501-1099
NPI assigned
Feb 15, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 17, 2025

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
Professional Counselor 101YP2500X 10290 SC Primary

Addresses

Primary practice location

651 Scholar Way Ste 101
Summerville, SC 29486-3052

Mailing address

PO Box 1561
Red Oak, GA 30272-1561
Phone (863) 244-3998

Other practice location 1

1030 Fayetteville Rd SE
Atlanta, GA 30316-2921
Phone (863) 244-3998

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
I20250114003751 SC Practitioner - Mental Health Counselor 7416485792 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Charleston Counseling Center PCGroup PAC ID 6204125107, 186 clinicians

Practice addresses (Care Compare)

651 Scholar Way
Suite 101
Summerville, SC 29486-3052
Phone (630) 884-9012

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
10290SCMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Charleston Counseling Center PC Mental Health CurrentSince Apr 28, 2025 Accepting new patients
Socalm LLC Professional CurrentSince Nov 11, 2024 Accepting new patients
Myrtle Beach Counseling Center Mental Health PastSince Aug 6, 2019 Accepting new patients

Locations

871 Lowcountry Blvd
Ste 200
Mt Pleasant, SC 29464
Phone (253) 346-0137

651 Scholar Way
Ste 101
Summerville, SC 29486
Phone (630) 884-9012

Organizations & group practices 3

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": "1644883200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1742169600000",
    "number": "1508511809",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1561",
            "city": "RED OAK",
            "state": "GA",
            "postal_code": "302721561",
            "telephone_number": "863-244-3998"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "651 SCHOLAR WAY STE 101",
            "city": "SUMMERVILLE",
            "state": "SC",
            "postal_code": "294863052",
            "telephone_number": "843-501-1099"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1030 Fayetteville Rd SE",
            "address_purpose": "LOCATION",
            "city": "Atlanta",
            "state": "GA",
            "postal_code": "303162921",
            "country_code": "US",
            "telephone_number": "863-244-3998",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BROWN",
        "first_name": "KIAVANNA",
        "middle_name": "L",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-02-15",
        "last_updated": "2025-03-17",
        "certification_date": "2025-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "SC",
            "license": "10290",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Summerville, SC

Sources for this page

Verify at the official NPI Registry.