Individual provider Active NPI

Patricia Kelly Card, LPC

  • Professional Counselor
  • Columbia, SC
National Provider Identifier
1639774094
Registry record updated Mar 1, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
8462 Issued in SC
Practice address
113 Executive Pointe Blvd
Columbia, SC 29210-5681
Phone
(803) 477-3736
NPI assigned
Dec 3, 2020
Last updated
Mar 1, 2023By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 1, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X 8462 SC Primary

Addresses

Primary practice location

113 Executive Pointe Blvd
Columbia, SC 29210-5681

Mailing address

3560 Ash St
Myrtle Beach, SC 29577-5019
Phone (954) 451-7845

Other practice location 1

1551 21st Ave N Ste 17
Myrtle Beach, SC 29577-7496
Phone (843) 868-6200

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
I20240110002996 SC Practitioner - Mental Health Counselor 2860843273 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Thrive Counseling LLCGroup PAC ID 0749458420, 1,187 clinicians

Practice addresses (Care Compare)

113 Executive Pointe Blvd
Suite 104
Columbia, SC 29210-8681
Phone (803) 477-3736

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
8462SCMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Thrive Counseling LLC CurrentSince Jan 1, 2024 Accepting new patients
Etheria Counseling LLC PastSince Aug 25, 2024 Accepting new patients
Good Vibes Therapy Center, LLC Professional PastSince Dec 1, 2020 Accepting new patients

Locations

113 Executive Pointe Blvd
Ste 104
Columbia, SC 29210
Phone (803) 477-3736

4975 Lacross Rd
Ste 351
North Charleston, SC 29406
Phone (800) 309-1159

1000 Jefferson St
Ste 2C
Lynchburg, VA 24504
Phone (434) 528-3263

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1606953600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1677628800000",
    "number": "1639774094",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3560 ASH ST",
            "city": "MYRTLE BEACH",
            "state": "SC",
            "postal_code": "295775019",
            "telephone_number": "954-451-7845"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "113 EXECUTIVE POINTE BLVD",
            "city": "COLUMBIA",
            "state": "SC",
            "postal_code": "292105681",
            "telephone_number": "803-477-3736"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1551 21st Ave N Ste 17",
            "address_purpose": "LOCATION",
            "city": "Myrtle Beach",
            "state": "SC",
            "postal_code": "295777496",
            "country_code": "US",
            "telephone_number": "843-868-6200",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CARD",
        "first_name": "PATRICIA",
        "middle_name": "KELLY",
        "credential": "LPC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-12-03",
        "last_updated": "2023-03-01",
        "certification_date": "2023-03-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "SC",
            "license": "8462",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Columbia, SC

Sources for this page

Verify at the official NPI Registry.