Individual provider Active NPI

Katherine M Tarleton, MFT, LMFT

  • Marriage & Family Therapist
  • Greenville, SC
National Provider Identifier
1629631064
Registry record updated Oct 28, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
8127 Issued in SC
Practice address
430 Woodruff Rd Ste 450
Greenville, SC 29607-3443
Phone
(864) 400-5130
Fax
(864) 818-4697
NPI assigned
Apr 22, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 28, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Marriage & Family Therapist 106H00000X 8127 SC Primary

Addresses

Primary practice location

430 Woodruff Rd Ste 450
Greenville, SC 29607-3443

Mailing address

119 Kingscreek Dr
Greer, SC 29650-5111

Other practice location 1

25 Woods Lake Rd Ste 712
Greenville, SC 29607-2765
Phone (864) 242-0005

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
I20241121003884 SC Practitioner - Marriage and Family Therapist 9335674738 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Marriage and Family Therapist
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Upstate Ellie LLCGroup PAC ID 3577938224, 8 clinicians

Practice addresses (Care Compare)

430 Woodruff Rd
Suite 450
Greenville, SC 29607-3443
Phone (864) 400-5130

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
8127SCMDGeriatric Pharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Upstate Ellie LLC Marriage & Family Therapist CurrentSince Dec 2, 2024 Accepting new patients

Locations

430 Woodruff Rd
Ste 450
Greenville, SC 29607
Phone (864) 400-5130

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": "1555891200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1730073600000",
    "number": "1629631064",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "119 KINGSCREEK DR",
            "city": "GREER",
            "state": "SC",
            "postal_code": "296505111"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "430 WOODRUFF RD STE 450",
            "city": "GREENVILLE",
            "state": "SC",
            "postal_code": "296073443",
            "telephone_number": "864-400-5130",
            "fax_number": "864-818-4697"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "25 Woods Lake Rd Ste 712",
            "address_purpose": "LOCATION",
            "city": "Greenville",
            "state": "SC",
            "postal_code": "296072765",
            "country_code": "US",
            "telephone_number": "864-242-0005",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "TARLETON",
        "first_name": "KATHERINE",
        "middle_name": "M",
        "credential": "MFT, LMFT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-04-22",
        "last_updated": "2024-10-28",
        "certification_date": "2024-10-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "SC",
            "license": "8127",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Greenville, SC

Sources for this page

Verify at the official NPI Registry.