Individual provider Active NPI

Latoya C.T. Edwards, LPC

  • Professional Counselor
  • Columbia, SC
National Provider Identifier
1528480068
Registry record updated Apr 15, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
5629 Issued in SC
Practice address
1717 Gervais St
Ste. 204
Columbia, SC 29201-3415
Phone
(803) 740-0966
Fax
(803) 741-5801
NPI assigned
Jan 17, 2014
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 15, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X 5629 SC Primary

Addresses

Primary practice location

1717 Gervais St
Ste. 204
Columbia, SC 29201-3415

Mailing address

1717 Gervais St
Ste. 204
Columbia, SC 29201-3415
Phone (803) 740-0966

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
I20240501000238 SC Practitioner - Mental Health Counselor 3971943432 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2010
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)

440 Knox Abbott Dr
Suite 425
Cayce, SC 29033-4353
Phone (843) 501-1099

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
5629SCMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Charleston Counseling Center PC Professional CurrentSince Apr 18, 2024 Accepting new patients
Myrtle Beach Counseling Center PastSince Aug 6, 2019 Accepting new patients

Locations

440 Knox Abbott Dr
Ste 425
Cayce, SC 29033

3600 Forest Dr
Ste 302
Columbia, SC 29204
Phone (803) 699-8887

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

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

Organizations & group practices 2

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": "1389916800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1713139200000",
    "number": "1528480068",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1717 GERVAIS ST",
            "address_2": "STE. 204",
            "city": "COLUMBIA",
            "state": "SC",
            "postal_code": "292013415",
            "telephone_number": "803-740-0966",
            "fax_number": "803-741-5801"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1717 GERVAIS ST",
            "address_2": "STE. 204",
            "city": "COLUMBIA",
            "state": "SC",
            "postal_code": "292013415",
            "telephone_number": "803-740-0966",
            "fax_number": "803-741-5801"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EDWARDS",
        "first_name": "LATOYA",
        "middle_name": "C.T.",
        "name_prefix": "Mrs.",
        "credential": "LPC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-01-17",
        "last_updated": "2024-04-15",
        "certification_date": "2024-04-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "SC",
            "license": "5629",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Columbia, SC

Sources for this page

Verify at the official NPI Registry.