NPIMap

Organization Active NPI

Crescent Child Development Services, LLC

  • Behavior Analyst
  • North Charleston, SC
National Provider Identifier
1720514938
Registry record updated May 8, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior AnalystTaxonomy code 103K00000X
Legal business name
CRESCENT CHILD DEVELOPMENT SERVICES, LLC
Practice address
2810 Ashley Phosphate Rd
B-11
North Charleston, SC 29418-6405
Phone
(843) 813-1538
Fax
(888) 813-3318
NPI assigned
May 8, 2017
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 8, 2017

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

Authorized official

Name
Ms. Tara Marie GregoriNPI 1780809335
Title
Owner/Director
Phone
(843) 813-1538

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior AnalystGroup: 193200000X MULTI-SPECIALTY GROUP 103K00000X Primary
Assistant Behavior AnalystGroup: 193200000X MULTI-SPECIALTY GROUP 106E00000X
Speech-Language PathologistGroup: 193200000X MULTI-SPECIALTY GROUP 235Z00000X 2212 SC

Addresses

Primary practice location

2810 Ashley Phosphate Rd
B-11
North Charleston, SC 29418-6405

Mailing address

966 Governors CT
Mount Pleasant
Mount Pleasant, SC 29464-9257
Phone (843) 813-1538

National Provider Directory

National Provider Directory
Tax ID family
Crescent Child Development Services2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Practitioners & affiliated clinicians

Practitioners 20

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 20

NPI Registry JSON

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

{
    "created_epoch": "1494201600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1494201600000",
    "number": "1720514938",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "966 GOVERNORS CT",
            "address_2": "MOUNT PLEASANT",
            "city": "MOUNT PLEASANT",
            "state": "SC",
            "postal_code": "294649257",
            "telephone_number": "843-813-1538",
            "fax_number": "888-813-3318"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2810 ASHLEY PHOSPHATE RD",
            "address_2": "B-11",
            "city": "NORTH CHARLESTON",
            "state": "SC",
            "postal_code": "294186405",
            "telephone_number": "843-813-1538",
            "fax_number": "888-813-3318"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CRESCENT CHILD DEVELOPMENT SERVICES, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-05-08",
        "last_updated": "2017-05-08",
        "status": "A",
        "authorized_official_last_name": "GREGORI",
        "authorized_official_first_name": "TARA",
        "authorized_official_middle_name": "MARIE",
        "authorized_official_title_or_position": "OWNER/DIRECTOR",
        "authorized_official_telephone_number": "843-813-1538",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Behavior Analyst",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "106E00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Assistant Behavior Analyst",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Speech-Language Pathologist",
            "state": "SC",
            "license": "2212",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in North Charleston, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 8, 2017; 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.