Geneva Bradshaw, LPCC
Individual provider Active NPI Professional Counselor · Camden, SC
NPI 1609290907 · NPPES record last updated Jan 21, 2025
Key facts
- NPI
- 1609290907
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Professional Counselor 101YP2500X
- License
- 168477 (KY)
- Practice address
- 704 Saint Paul Rd
Camden, SC 29020-1562 - Phone
- (270) 799-6628
- NPI assigned
- Feb 7, 2014
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 12
Medicare Care Compare profile
- Specialty
- Mental Health Counselor
- Education
- Other, 2005
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Sandhills Medical Foundation, Inc.
Practice addresses (Care Compare)
40 Baldwin Ave
Lugoff, SC 29078-9406
Phone (803) 408-3262
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in SC
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: No · Power mobility devices: No · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20250325001711 | SC | Practitioner - Mental Health Counselor | 6709309354 | Reassigns benefits to 4 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 168477 | KY | MD | Professional Counselor |
| 9834 | SC | MD | Physical Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Sandhills Medical Foundation, Inc. | Current | Accepting new patients | |
| Sandhills Medical Foundation, Inc. | Current |
Accepting new patients | |
| Sandhills Medical Foundation, Inc. | Current |
Accepting new patients | |
| Sandhills Medical Foundation, Inc. | Current |
Accepting new patients | |
| Sandhills Medical Foundation, Inc. | Current | Accepting new patients | |
| Sandhills Medical Foundation, Inc. | Current | Accepting new patients | |
| Sandhills Medical Foundation, Inc. | Current |
Accepting new patients | |
| Sandhills Medical Foundation, Inc. | Current | Accepting new patients | |
| Lifeskills, Inc. | Past |
Accepting new patients | |
| Sandhills Medical Foundation | Past | Accepting new patients |
Locations
103 Main St N
Bldg N
Bethune, SC 29009
Phone (843) 334-7145
2611 Liberty Hill Rd
Camden, SC 29020
Phone (803) 432-3447
409 E Church St
Jefferson, SC 29718
Phone (843) 658-3005
205 W Marion St
Kershaw, SC 29067
Phone (803) 475-4701
40 Baldwin Ave
Lugoff, SC 29078
Phone (803) 408-3262
645 S Seventh St
Mc Bee, SC 29101
Phone (803) 475-4701
727 S Seventh St
Mc Bee, SC 29101
Phone (843) 335-8291
126 N Pearl St
Pageland, SC 29728
Phone (843) 675-5004
30 Cuttino Rd
Sumter, SC 29150
Phone (803) 778-2442
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | |||
| Professional Counselor | 101YP2500X | 168477 | KY | Yes |
Addresses
Primary practice location
704 Saint Paul Rd
Camden, SC 29020-1562
Mailing address
380 Suwannee Trail St
Bowling Green, KY 42103-7956
Phone (270) 901-5000
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 7100417810 | Medicaid | KY |
Other providers in Camden, SC
- Ann Johnson Boykin
- Audrey Ellerbe Boykin
- Jenifer Boykin
- Sarah Creed Bradley
- Elizabeth Noelle Bradshaw
- Joyce J Branham
- Melinda Branham
- Thomas Gunnar Branham
- Mary Myers Bridges
- Jerry Lenard Brinson
All providers in Camden, SC · Professional Counselor in South Carolina
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 21, 2025. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.