Active NPI
Mack Miles Warren, LPC
- Professional Counselor
- Columbia, SC
National Provider Identifier
1720001571
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- 1016
- Practice address
- 1330 Taylot at Marion St
Palmetto Baptist Counseling Center
Columbia, SC 29201 - Phone
- (803) 296-2548
- Fax
- (803) 296-2525
- NPI assigned
- Jul 25, 2006
- Sex
- Male
- 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 |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | 1016 | SC | Primary |
Addresses
Primary practice location
1330 Taylot at Marion St
Palmetto Baptist Counseling Center
Columbia, SC 29201
Mailing address
1321 Lady Street, First Floor
Palmetto Health
Columbia, SC 29201
Phone (803) 296-2548
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1016 | SC | MD | Optician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1153785600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1720001571",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1321 LADY STREET, FIRST FLOOR",
"address_2": "PALMETTO HEALTH",
"city": "COLUMBIA",
"state": "SC",
"postal_code": "29201",
"telephone_number": "803-296-2548",
"fax_number": "803-296-2525"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1330 TAYLOT AT MARION ST",
"address_2": "PALMETTO BAPTIST COUNSELING CENTER",
"city": "COLUMBIA",
"state": "SC",
"postal_code": "29201",
"telephone_number": "803-296-2548",
"fax_number": "803-296-2525"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WARREN",
"first_name": "MACK",
"middle_name": "MILES",
"name_prefix": "Mr.",
"credential": "LPC",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-07-25",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "SC",
"license": "1016",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Columbia, SC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.