NPIMap

Organization Active NPI

Family Support Services

  • Psychiatry Physician
  • Sumter, SC
National Provider Identifier
1679751127
Registry record updated Feb 7, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
9114 Issued in SC
Legal business name
FAMILY SUPPORT SERVICES
Practice address
130 Broad St
Suite B
Sumter, SC 29150-4237
Phone
(803) 774-4377
Fax
(803) 774-4378
NPI assigned
Feb 7, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 7, 2008

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

Authorized official

Name
Mr. Terrance Wells, M.ED AND LPC-I
Title
Executive Director
Phone
(803) 774-4377

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 2084P0800X 9114 SC Primary

Addresses

Primary practice location

130 Broad St
Suite B
Sumter, SC 29150-4237

Mailing address

130 Broad St
Suite B
Sumter, SC 29150-4237
Phone (803) 774-4377

Other identifiers 1

IdentifierTypeStateIssuer
GP4365MedicaidSC

National Provider Directory

National Provider Directory

Locations

130 Broad St
#B
Sumter, SC 29150
Phone (803) 774-4377

NPI Registry JSON

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

{
    "created_epoch": "1202342400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1202342400000",
    "number": "1679751127",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "130 BROAD ST",
            "address_2": "SUITE B",
            "city": "SUMTER",
            "state": "SC",
            "postal_code": "291504237",
            "telephone_number": "803-774-4377",
            "fax_number": "803-774-4378"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "130 BROAD ST",
            "address_2": "SUITE B",
            "city": "SUMTER",
            "state": "SC",
            "postal_code": "291504237",
            "telephone_number": "803-774-4377",
            "fax_number": "803-774-4378"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FAMILY SUPPORT SERVICES",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-02-07",
        "last_updated": "2008-02-07",
        "status": "A",
        "authorized_official_last_name": "WELLS",
        "authorized_official_first_name": "TERRANCE",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "803-774-4377",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "M.ED AND LPC-I"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "SC",
            "license": "9114",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "GP4365",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Sumter, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 7, 2008; 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.