Organization Active NPI

MBS Health & Wellness Solutions, LLC

  • Clinical Social Worker
  • Rock Hill, SC
National Provider Identifier
1669925681
Registry record updated Jul 26, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
CP-11094 Issued in SC
Legal business name
MBS HEALTH & WELLNESS SOLUTIONS, LLC
Practice address
331 E Main St
Suite 204
Rock Hill, SC 29730-5383
Phone
(980) 474-7757
NPI assigned
Jul 26, 2016
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 26, 2016

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

Authorized official

Name
Shukairo Townsend, LCSW, LCAS
Title
President
Phone
(980) 474-7757

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) CounselorGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 101YA0400X L0215 NC
Clinical Social WorkerGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 1041C0700X CP-11094 SC Primary
Clinical Social WorkerGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 1041C0700X C008389 NC

Addresses

Primary practice location

331 E Main St
Suite 204
Rock Hill, SC 29730-5383

Mailing address

331 E Main St
Suite 204
Rock Hill, SC 29730-5383
Phone (980) 474-7757

Other identifiers 1

IdentifierTypeStateIssuer
1659666444MedicaidNC

National Provider Directory

National Provider Directory

Locations

331 E Main St
Ste 204
Rock Hill, SC 29730
Phone (980) 474-7757

NPI Registry JSON

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

{
    "created_epoch": "1469491200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1469491200000",
    "number": "1669925681",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "331 E MAIN ST",
            "address_2": "SUITE 204",
            "city": "ROCK HILL",
            "state": "SC",
            "postal_code": "297305383",
            "telephone_number": "980-474-7757"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "331 E MAIN ST",
            "address_2": "SUITE 204",
            "city": "ROCK HILL",
            "state": "SC",
            "postal_code": "297305383",
            "telephone_number": "980-474-7757"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MBS HEALTH & WELLNESS SOLUTIONS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-07-26",
        "last_updated": "2016-07-26",
        "status": "A",
        "authorized_official_last_name": "TOWNSEND",
        "authorized_official_first_name": "SHUKAIRO",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "980-474-7757",
        "authorized_official_credential": "LCSW, LCAS"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "NC",
            "license": "L0215",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Social Worker, Clinical",
            "state": "SC",
            "license": "CP-11094",
            "primary": true
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Social Worker, Clinical",
            "state": "NC",
            "license": "C008389",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1659666444",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Rock Hill, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 26, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.