Active NPI
Madeline Kelly
- Addiction (Substance Use Disorder) Counselor
- Hartsville, SC
National Provider Identifier
1699595793
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Addiction (Substance Use Disorder) Counselor
- Practice address
- 1451 Retail Row
Hartsville, SC 29550-4258 - Phone
- (800) 805-6989
- NPI assigned
- Oct 14, 2024
- Last updated
- Oct 14, 2024
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Addiction (Substance Use Disorder) Counselor | 101YA0400X | Primary |
Addresses
Primary practice location
1451 Retail Row
Hartsville, SC 29550-4258
Mailing address
464 Elmore Rd
Bishopville, SC 29010-7729
Phone (803) 229-5681
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1728864000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1728864000000",
"number": "1699595793",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "464 ELMORE RD",
"city": "BISHOPVILLE",
"state": "SC",
"postal_code": "290107729",
"telephone_number": "803-229-5681"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1451 RETAIL ROW",
"city": "HARTSVILLE",
"state": "SC",
"postal_code": "295504258",
"telephone_number": "800-805-6989"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KELLY",
"first_name": "MADELINE",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2024-10-14",
"last_updated": "2024-10-14",
"certification_date": "2024-10-14",
"status": "A"
},
"taxonomies": [
{
"code": "101YA0400X",
"taxonomy_group": "",
"desc": "Counselor, Addiction (Substance Use Disorder)",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Hartsville, SC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 14, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.