Individual provider Active NPI

Angela Lynn Waldrop, LMFT

  • Marriage & Family Therapist
  • Columbia, SC
National Provider Identifier
1609303650
Registry record updated Oct 28, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
4680 Issued in SC
Practice address
2917 Millwood Ave BLDG B
Columbia, SC 29205-1334
Phone
(803) 814-6218
Fax
(855) 490-9560
NPI assigned
May 20, 2017
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 28, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Marriage & Family Therapist 106H00000X 1833 NC
Marriage & Family Therapist 106H00000X 4680 SC Primary

Addresses

Primary practice location

2917 Millwood Ave BLDG B
Columbia, SC 29205-1334

Mailing address

2917 Millwood Ave BLDG B
Columbia, SC 29205-1334
Phone (803) 814-6218

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
I20240422003032 SC Practitioner - Marriage and Family Therapist 1951740273 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Marriage and Family Therapist
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Foundations Family Life Counseling and Consulting LLCGroup PAC ID 0143669465, 2 clinicians

Practice addresses (Care Compare)

2917 Millwood Ave
BLDG B
Columbia, SC 29205-1334
Phone (803) 814-6218

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
4680SCMDPublic Health Dentist

Practice roles

OrganizationSpecialtyStatusNew patients
Foundations Family Life Counseling and Consulting, LLC CurrentSince Feb 21, 2024 Accepting new patients

Locations

2917 Millwood Ave
#B
Columbia, SC 29205
Phone (803) 413-2662

Organizations & group practices 1

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": "1495238400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1572220800000",
    "number": "1609303650",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2917 MILLWOOD AVE BLDG B",
            "city": "COLUMBIA",
            "state": "SC",
            "postal_code": "292051334",
            "telephone_number": "803-814-6218",
            "fax_number": "855-490-9560"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2917 MILLWOOD AVE BLDG B",
            "city": "COLUMBIA",
            "state": "SC",
            "postal_code": "292051334",
            "telephone_number": "803-814-6218",
            "fax_number": "855-490-9560"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WALDROP",
        "first_name": "ANGELA",
        "middle_name": "LYNN",
        "name_prefix": "Mrs.",
        "credential": "LMFT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-05-20",
        "last_updated": "2019-10-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "NC",
            "license": "1833",
            "primary": false
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "SC",
            "license": "4680",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Columbia, SC

Sources for this page

Verify at the official NPI Registry.