Greater Alliance Behavioral Health

Primary specialty

Psychiatric/Mental Health Registered NurseTaxonomy code 163WP0808X

Legal business name

GREATER ALLIANCE BEHAVIORAL HEALTH

Practice address

6037 Landry LN
Indian Land, SC 29707-6060

Phone

(803) 979-6171

Fax

(704) 817-1470

NPI assigned

Aug 3, 2023

Last updated

Nov 20, 2023By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Celena Nicole Shivers, APRN PMHNPNPI 1033828207

Title

Owner

Phone

(803) 979-6171

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in NC, SC2 enrollments

Enrollment records 2

Locations

Practitioners 2

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.

• Celena Nicole Shivers, PMHNP

  • Psychiatric/Mental Health Nurse Practitioner
  • Charlotte, NC
  • NPI 1033828207

  SC

  Medicare reassignment NPD Authorized official
• Tina Cantrell, PMHNP

  • Psychiatric/Mental Health Nurse Practitioner
  • Fort Mill, SC
  • NPI 1811813603
  NPD (past)

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

{
    "created_epoch": "1691020800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1700438400000",
    "number": "1639851132",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8180 REGENT PKWY STE 109",
            "city": "FORT MILL",
            "state": "SC",
            "postal_code": "297158417",
            "telephone_number": "803-979-6171",
            "fax_number": "704-817-1470"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6037 LANDRY LN",
            "city": "INDIAN LAND",
            "state": "SC",
            "postal_code": "297076060",
            "telephone_number": "803-979-6171",
            "fax_number": "704-817-1470"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GREATER ALLIANCE BEHAVIORAL HEALTH",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-08-03",
        "last_updated": "2023-11-20",
        "certification_date": "2023-11-20",
        "status": "A",
        "authorized_official_last_name": "SHIVERS",
        "authorized_official_first_name": "CELENA",
        "authorized_official_middle_name": "NICOLE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "803-979-6171",
        "authorized_official_credential": "APRN PMHNP"
    },
    "taxonomies": [
        {
            "code": "163WP0808X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Psychiatric/Mental Health",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "261QM1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Multi-Specialty",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI",
            "identifier": "1033828207",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Sharon Glenn, M.S., CCC-SLP
• Rachel Marie Gmach, PT
• Victoria Godfrey, M.ED., IECMH-E
• Daniel Matthew Goldstein, PT
• Graceful Physical Therapy and Performance LLC
• Kerrion Green
• Amanda Gregory, FNP
• Krisma Gregory, PHARM.D.
• Julia Greiner, LAT, ATC
• Pennshelia Griffin, PT, DPT

• Psychiatric/Mental Health Registered Nurse in Indian Land, SC
• Providers in Indian Land, SC by specialty
• Psychiatric/Mental Health Registered Nurse in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 20, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.