NPIMap

Organization Active NPI

Palmetto Lowcountry Behavioral Health, LLC

  • Psychiatry Physician
  • Charleston, SC
National Provider Identifier
1598072282
Registry record updated Sep 2, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
Legal business name
PALMETTO LOWCOUNTRY BEHAVIORAL HEALTH, LLC
Practice address
2777 Speissegger Dr.
Charleston, SC 29405-8235
Phone
(843) 747-5830
Fax
(843) 745-5115
NPI assigned
Sep 2, 2010
Organization subpart
Yes
Parent organization
PALMETTO LOWCOUNTRY BEHAVIORAL HEALTH, LLCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Sep 2, 2010

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

Authorized official

Name
Cherie Tolley
Title
Chief Executive Officer
Phone
(843) 747-5830

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 2084P0800X Primary

Addresses

Primary practice location

2777 Speissegger Dr.
Charleston, SC 29405-8235

Mailing address

2777 Speissegger Dr.
Charleston, SC 29405-8235
Phone (843) 747-5830

Other identifiers 2

IdentifierTypeStateIssuer
A00729MedicaidSC
RTF021MedicaidSC

National Provider Directory

National Provider Directory
Tax ID family
Palmetto Ocean View Behvl3 organizations share this tax ID, including this one
Part of
Palmetto Ocean View Behvl

Other organizations with this tax ID 2

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1283385600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1283385600000",
    "number": "1598072282",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2777 SPEISSEGGER DR.",
            "city": "CHARLESTON",
            "state": "SC",
            "postal_code": "294058235",
            "telephone_number": "843-747-5830",
            "fax_number": "843-745-5115"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2777 SPEISSEGGER DR.",
            "city": "CHARLESTON",
            "state": "SC",
            "postal_code": "294058235",
            "telephone_number": "843-747-5830",
            "fax_number": "843-745-5115"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PALMETTO LOWCOUNTRY BEHAVIORAL HEALTH, LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "PALMETTO LOWCOUNTRY BEHAVIORAL HEALTH, LLC",
        "enumeration_date": "2010-09-02",
        "last_updated": "2010-09-02",
        "status": "A",
        "authorized_official_last_name": "TOLLEY",
        "authorized_official_first_name": "CHERIE",
        "authorized_official_title_or_position": "CHIEF EXECUTIVE OFFICER",
        "authorized_official_telephone_number": "843-747-5830"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "A00729",
            "state": "SC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "RTF021",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Charleston, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 2, 2010; 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.