NPIMap

Organization Active NPI

South Carolina Dept of Mental Health Accounting Office

Doing business as Greenville Mental Health Center

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Greenville, SC
National Provider Identifier
1619995370
Registry record updated Dec 18, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health Clinic/Center (Including Community Mental Health Center)Taxonomy code 261QM0801X
Legal business name
SOUTH CAROLINA DEPT OF MENTAL HEALTH ACCOUNTING OFFICE
Doing business as
Greenville Mental Health Center
Practice address
124 Mallard St
Greenville, SC 29601-4046
Phone
(864) 241-1040
Fax
(864) 241-1215
NPI assigned
Jul 18, 2006
Last updated
Dec 18, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 18, 2023

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

Authorized official

Name
Jennifer Crowe
Title
Billing
Phone
(864) 241-1040

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Clinic/Center (Including Community Mental Health Center) 261QM0801X Primary

Addresses

Primary practice location

124 Mallard St
Greenville, SC 29601-4046

Mailing address

124 Mallard St
Greenville, SC 29601-4046
Phone (864) 241-1040

Other identifiers 1

IdentifierTypeStateIssuer
301100MedicaidSC

Other names 1

  • Greenville Mental Health Center Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SC

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040624000139 SC Part B Supplier - Clinic/Group Practice 9032021175 Receives reassigned benefits from 23 practitioners
1 other NPI on this enrollment
Practice locations: Greenville, SC

Other NPIs with the same Medicare PAC ID 10

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory

Ownership & related parties

All facility ownership & control disclosures 4

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
South Carolina Dept of Mental Health Accounting OfficeColumbia, SC, CCN 424005 Hospital 5% Or Greater Direct Ownership Interest (100%) Feb 1, 1978
Patrick B Harris Psychiatric HospitalAnderson, SC, CCN 424011 Hospital 5% Or Greater Direct Ownership Interest
Operational/Managerial Control		 Sep 7, 2016
Dec 29, 1986
CM Tucker Jr Nursing CareColumbia, SC, CCN 425074 Skilled nursing facility 5% Or Greater Direct Ownership Interest (100%)
Operational/Managerial Control		 Jan 1, 1970
Jan 1, 1970
C.M. Tucker Jr Nursing Care Center-Roddey PavillionColumbia, SC, CCN 425360 Skilled nursing facility 5% Or Greater Direct Ownership Interest Jan 1, 2006

Owned or controlled facilities with NPI records 4

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Practitioners & affiliated clinicians

Practitioners 23

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.

View all 23

NPI Registry JSON

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

{
    "created_epoch": "1153180800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1702857600000",
    "number": "1619995370",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "124 MALLARD ST",
            "city": "GREENVILLE",
            "state": "SC",
            "postal_code": "296014046",
            "telephone_number": "864-241-1040",
            "fax_number": "864-241-1215"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "124 MALLARD ST",
            "city": "GREENVILLE",
            "state": "SC",
            "postal_code": "296014046",
            "telephone_number": "864-241-1040",
            "fax_number": "864-241-1215"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTH CAROLINA DEPT OF MENTAL HEALTH ACCOUNTING OFFICE",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-18",
        "last_updated": "2023-12-18",
        "certification_date": "2023-12-18",
        "status": "A",
        "authorized_official_last_name": "CROWE",
        "authorized_official_first_name": "JENNIFER",
        "authorized_official_title_or_position": "BILLING",
        "authorized_official_telephone_number": "864-241-1040"
    },
    "taxonomies": [
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "301100",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Greenville Mental Health Center",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Greenville Mental Health Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Greenville, SC

Sources for this page

Verify at the official NPI Registry.