NPIMap

Organization Active NPI

Palmetto Comprehensive Behavioral Health

Doing business as PCBH

  • Community/Behavioral Health Agency
  • Columbia, SC
National Provider Identifier
1609267822
Registry record updated Feb 10, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Behavioral Health AgencyTaxonomy code 251S00000X
Legal business name
PALMETTO COMPREHENSIVE BEHAVIORAL HEALTH
Doing business as
PCBH
Practice address
108 Caughman Ridge Rd
Columbia, SC 29209-3114
Phone
(803) 477-7928
NPI assigned
Feb 10, 2015
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 10, 2015

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

Authorized official

Name
Dr. Shaka Abdul Moustafa I, PH.D.NPI 1336345255
Title
Ceo/Owner
Phone
(803) 477-7928

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Behavioral Health Agency 251S00000X Primary

Addresses

Primary practice location

108 Caughman Ridge Rd
Columbia, SC 29209-3114

Mailing address

108 Caughman Ridge Rd
Columbia, SC 29209-3114
Phone (803) 477-7928

Other names 1

  • PCBH Doing business as

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1423526400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1423526400000",
    "number": "1609267822",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "108 CAUGHMAN RIDGE RD",
            "city": "COLUMBIA",
            "state": "SC",
            "postal_code": "292093114",
            "telephone_number": "803-477-7928"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "108 CAUGHMAN RIDGE RD",
            "city": "COLUMBIA",
            "state": "SC",
            "postal_code": "292093114",
            "telephone_number": "803-477-7928"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PALMETTO COMPREHENSIVE BEHAVIORAL HEALTH",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-02-10",
        "last_updated": "2015-02-10",
        "status": "A",
        "authorized_official_last_name": "MOUSTAFA",
        "authorized_official_first_name": "SHAKA",
        "authorized_official_middle_name": "ABDUL",
        "authorized_official_title_or_position": "CEO/OWNER",
        "authorized_official_telephone_number": "803-477-7928",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_name_suffix": "I",
        "authorized_official_credential": "PH.D."
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "PCBH",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Columbia, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 10, 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.