NPIMap

Organization Active NPI

Trinity Behavioral Care Dillon Office

  • Community/Behavioral Health Agency
  • Dillon, SC
National Provider Identifier
1740340801
Registry record updated Jun 24, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Behavioral Health AgencyTaxonomy code 251S00000X
License
OTP-004 Issued in SC
Legal business name
TRINITY BEHAVIORAL CARE DILLON OFFICE
Practice address
204 Martin Luther King Jr Blvd
Dillon, SC 29536-3304
Phone
(843) 774-6591
Fax
(843) 774-1409
NPI assigned
Dec 11, 2006
Last updated
Jun 24, 2008By the provider in NPPES
Organization subpart
Yes
Parent organization
TRINITY BEHAVIORAL CAREAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jun 24, 2008

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

Authorized official

Name
Mr. William T Oconnor
Title
Executive Director
Phone
(843) 423-8292

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X OTP-004 SC
Community/Behavioral Health Agency 251S00000X OTP-004 SC Primary

Addresses

Primary practice location

204 Martin Luther King Jr Blvd
Dillon, SC 29536-3304

Mailing address

204 Martin Luther King Jr Blvd
Dillon, SC 29536-3304
Phone (843) 774-6591

Other identifiers 1

IdentifierTypeStateIssuer
AD28DNMedicaidSC

National Provider Directory

National Provider Directory
Tax ID family
Trinity Behavioral Care Dillon Office6 organizations share this tax ID, including this one
Part of
Trinity Behavioral Care Dillon Office

Other organizations with this tax ID 5

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

Locations

204 Martin Luther King Jr Blvd
Dillon, SC 29536
Phone (843) 774-6591

Practitioners & affiliated clinicians

Practitioners 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1165795200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1214265600000",
    "number": "1740340801",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "204 MARTIN LUTHER KING JR BLVD",
            "city": "DILLON",
            "state": "SC",
            "postal_code": "295363304",
            "telephone_number": "843-774-6591",
            "fax_number": "843-774-1409"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "204 MARTIN LUTHER KING JR BLVD",
            "city": "DILLON",
            "state": "SC",
            "postal_code": "295363304",
            "telephone_number": "843-774-6591",
            "fax_number": "843-774-1409"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TRINITY BEHAVIORAL CARE DILLON OFFICE",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "TRINITY BEHAVIORAL CARE",
        "enumeration_date": "2006-12-11",
        "last_updated": "2008-06-24",
        "status": "A",
        "authorized_official_last_name": "OCONNOR",
        "authorized_official_first_name": "WILLIAM",
        "authorized_official_middle_name": "T",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "843-423-8292",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "SC",
            "license": "OTP-004",
            "primary": false
        },
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "SC",
            "license": "OTP-004",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "AD28DN",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Dillon, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 24, 2008; 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.