Life Links Behavioral and Medical Group

Primary specialty

Community/Behavioral Health AgencyTaxonomy code 251S00000X

Legal business name

LIFE LINKS BEHAVIORAL AND MEDICAL GROUP

Practice address

503 E Main Street
Pamplico, SC 29583

Phone

(843) 616-4225

Fax

(843) 589-1248

NPI assigned

Aug 15, 2019

Organization subpart

No

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

Authorized official

Name

Dr. Tamiquia T. Simon

Title

Chief Executive Officer

Phone

(843) 616-4225

Specialties & licenses 2

Addresses

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

{
    "created_epoch": "1565827200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1565827200000",
    "number": "1700432606",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "928 HILLSIDE DR",
            "city": "PAMPLICO",
            "state": "SC",
            "postal_code": "295836810",
            "telephone_number": "843-616-4225",
            "fax_number": "843-589-1248"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "503 E MAIN STREET",
            "city": "PAMPLICO",
            "state": "SC",
            "postal_code": "29583",
            "telephone_number": "843-616-4225",
            "fax_number": "843-589-1248"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LIFE LINKS BEHAVIORAL AND MEDICAL GROUP",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-08-15",
        "last_updated": "2019-08-15",
        "status": "A",
        "authorized_official_last_name": "SIMON",
        "authorized_official_first_name": "TAMIQUIA",
        "authorized_official_middle_name": "T.",
        "authorized_official_title_or_position": "CHIEF EXECUTIVE OFFICER",
        "authorized_official_telephone_number": "843-616-4225",
        "authorized_official_name_prefix": "Dr."
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Community/Behavioral Health Agency in Pamplico, SC
• Providers in Pamplico, SC by specialty
• Community/Behavioral Health Agency in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 15, 2019; 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.