Individual provider Active NPI

Cristy Altman, LPES

  • School Psychologist
  • Florence, SC
National Provider Identifier
1730865072
Registry record updated Jun 22, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
School PsychologistTaxonomy code 103TS0200X
License
4661 Issued in SC
Practice address
1340 Celebration Blvd
Florence, SC 29501-5585
Phone
(843) 536-1182
Fax
(843) 536-1116
NPI assigned
Jun 22, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 22, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
School Psychologist 103TS0200X 4661 SC Primary

Addresses

Primary practice location

1340 Celebration Blvd
Florence, SC 29501-5585

Mailing address

225 Maple Dr
Pamplico, SC 29583-4346
Phone (843) 687-4456

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

LicenseStateTypeSpecialty
4661SCMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Wellspring Psychology Group LLC CurrentSince Jun 25, 2023 Accepting new patients

Locations

1340 Celebration Blvd
Florence, SC 29501
Phone (843) 536-1180

Organizations & group practices 1

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": "1687392000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1687392000000",
    "number": "1730865072",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "225 MAPLE DR",
            "city": "PAMPLICO",
            "state": "SC",
            "postal_code": "295834346",
            "telephone_number": "843-687-4456"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1340 CELEBRATION BLVD",
            "city": "FLORENCE",
            "state": "SC",
            "postal_code": "295015585",
            "telephone_number": "843-536-1182",
            "fax_number": "843-536-1116"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ALTMAN",
        "first_name": "CRISTY",
        "credential": "LPES",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-06-22",
        "last_updated": "2023-06-22",
        "certification_date": "2023-06-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TS0200X",
            "taxonomy_group": "",
            "desc": "Psychologist, School",
            "state": "SC",
            "license": "4661",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Florence, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 22, 2023; 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.