Acting Out Loud Therapy, LLC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

Legal business name

ACTING OUT LOUD THERAPY, LLC

Practice address

1156 Bowman Rd Unit 207
Mt Pleasant, SC 29464-3858

Phone

(818) 442-9055

NPI assigned

Jul 23, 2024

Last updated

Jul 23, 2024By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Shanta Payne, PSYD-LPC, CAGCSNPI 1356960371

Title

Owner/Clinician

Phone

(818) 442-9055

Specialties & licenses 2

Addresses

Other identifiers 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Shanta Payne, LPC

  • Mental Health Counselor
  • Mount Pleasant, SC
  • NPI 1356960371
  NPD Authorized official

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

{
    "created_epoch": "1721692800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1721692800000",
    "number": "1730917675",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1050 JOHNNIE DODDS BLVD UNIT 1283",
            "city": "MT PLEASANT",
            "state": "SC",
            "postal_code": "294652862",
            "telephone_number": "818-442-9055"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1156 BOWMAN RD UNIT 207",
            "city": "MT PLEASANT",
            "state": "SC",
            "postal_code": "294643858",
            "telephone_number": "818-442-9055"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ACTING OUT LOUD THERAPY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-07-23",
        "last_updated": "2024-07-23",
        "certification_date": "2024-07-23",
        "status": "A",
        "authorized_official_last_name": "PAYNE",
        "authorized_official_first_name": "SHANTA",
        "authorized_official_title_or_position": "OWNER/CLINICIAN",
        "authorized_official_telephone_number": "818-442-9055",
        "authorized_official_credential": "PSYD-LPC, CAGCS"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Professional",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "PC2334",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Professional Counselor in Mount Pleasant, SC
• Providers in Mount Pleasant, SC by specialty
• Professional Counselor in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 23, 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.