Palmetto Supportive Services

Primary specialty

Community/Behavioral Health AgencyTaxonomy code 251S00000X

Legal business name

PALMETTO SUPPORTIVE SERVICES

Practice address

25 Woods Lake Rd Ste 301
Suite 301
Greenville, SC 29607-2762

Phone

(864) 346-2800

Fax

(864) 272-1974

NPI assigned

Feb 11, 2015

Organization subpart

No

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

Authorized official

Name

Mr. Victor Austin Jr.

Title

President

Phone

(864) 346-2800

Specialties & licenses 7

Addresses

Locations

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

{
    "created_epoch": "1423612800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1423612800000",
    "number": "1518358696",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "25 WOODS LAKE RD STE 301",
            "address_2": "SUITE 301",
            "city": "GREENVILLE",
            "state": "SC",
            "postal_code": "296072762",
            "telephone_number": "864-346-2800",
            "fax_number": "864-272-1974"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "25 WOODS LAKE RD STE 301",
            "address_2": "SUITE 301",
            "city": "GREENVILLE",
            "state": "SC",
            "postal_code": "296072762",
            "telephone_number": "864-346-2800",
            "fax_number": "864-272-1974"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PALMETTO SUPPORTIVE SERVICES",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-02-11",
        "last_updated": "2015-02-11",
        "status": "A",
        "authorized_official_last_name": "AUSTIN",
        "authorized_official_first_name": "VICTOR",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "864-346-2800",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_name_suffix": "Jr."
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Professional",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YS0200X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, School",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "103K00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Behavior Analyst",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Marriage & Family Therapist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Community/Behavioral Health Agency in Greenville, SC
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• Community/Behavioral Health Agency in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 11, 2015; 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.