Individual provider Active NPI

Chantal Stith, MSN, APRN, PMHNP-BC

  • Nurse Practitioner
  • Charleston, SC
National Provider Identifier
1710698873
Registry record updated Jul 10, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
27891 Issued in SC
Practice address
65 Gadsden St
Charleston, SC 29401-1145
Phone
(607) 373-6041
NPI assigned
Dec 9, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 10, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Registered Nurse 163WP0808X 240887 SC
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 27891 SC
Nurse Practitioner 363L00000X 27891 SC Primary

Addresses

Primary practice location

65 Gadsden St
Charleston, SC 29401-1145

Mailing address

65 Gadsden St
Charleston, SC 29401-1145

Other practice location 1

3445 Ingleside Blvd
Ladson, SC 29456-4142
Phone (843) 797-4200

Other practice location 2

100A Central Ave Ste 102
Goose Creek, SC 29445-2920
Phone (607) 373-6041

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)
Enrolled
Credentials
Master of Science - Nursing, Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
240887SCMDPsychiatric/Mental Health Registered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Lantana Recovery of Connecticut, LLC CurrentSince Mar 12, 2024 Accepting new patients
Lantana Recovery CurrentSince Dec 10, 2023 Accepting new patients

Locations

65 Gadsden St
Charleston, SC 29401
Phone (843) 352-9982

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1670544000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1720569600000",
    "number": "1710698873",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "65 GADSDEN ST",
            "city": "CHARLESTON",
            "state": "SC",
            "postal_code": "294011145"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "65 GADSDEN ST",
            "city": "CHARLESTON",
            "state": "SC",
            "postal_code": "294011145",
            "telephone_number": "607-373-6041"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3445 Ingleside Blvd",
            "address_purpose": "LOCATION",
            "city": "Ladson",
            "state": "SC",
            "postal_code": "294564142",
            "country_code": "US",
            "telephone_number": "843-797-4200",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "100A Central Ave Ste 102",
            "address_purpose": "LOCATION",
            "city": "Goose Creek",
            "state": "SC",
            "postal_code": "294452920",
            "country_code": "US",
            "telephone_number": "607-373-6041",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "STITH",
        "first_name": "CHANTAL",
        "credential": "MSN, APRN, PMHNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-12-09",
        "last_updated": "2024-07-10",
        "certification_date": "2024-07-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WP0808X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Psychiatric/Mental Health",
            "state": "SC",
            "license": "240887",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "SC",
            "license": "27891",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "SC",
            "license": "27891",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Charleston, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 10, 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.

Verify at the official NPI Registry.