Psychotherapy and Consultation

Primary specialty

Community/Behavioral Health AgencyTaxonomy code 251S00000X

License

0069 Issued in SC

Legal business name

PSYCHOTHERAPY AND CONSULTATION

Practice address

504 Parkview Dr
Spartanburg, SC 29302-4019

Phone

(864) 504-0708

NPI assigned

Jun 16, 2016

Last updated

Aug 10, 2016By 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

Lisa L Judd, LISW-CPNPI 1417958448

Title

Sole Proprietor

Phone

(864) 504-0708

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in SC

Enrollment records 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.

• Lisa L Judd, MSW LISW-CP ACSW

  • Social Worker
  • Spartanburg, SC
  • NPI 1417958448
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1466035200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1470787200000",
    "number": "1740630045",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "504 PARKVIEW DR",
            "city": "SPARTANBURG",
            "state": "SC",
            "postal_code": "293024019",
            "telephone_number": "864-504-0708"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "504 PARKVIEW DR",
            "city": "SPARTANBURG",
            "state": "SC",
            "postal_code": "293024019",
            "telephone_number": "864-504-0708"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PSYCHOTHERAPY AND CONSULTATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-06-16",
        "last_updated": "2016-08-10",
        "status": "A",
        "authorized_official_last_name": "JUDD",
        "authorized_official_first_name": "LISA",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "SOLE PROPRIETOR",
        "authorized_official_telephone_number": "864-504-0708",
        "authorized_official_credential": "LISW-CP"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "SC",
            "license": "0069",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "SW1292-1417958448",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Amanda Kinney Pruitt, DO
• Daylee Jeane Alon Pruitt
• Michael B Pryor, MD
• Jennifer Dawn Psaltis, NP
• Psychiatric Associates of Spartanburg, PA
• PT Solutions of Acworth LLC
• Molly Ptasznik
• PTVP (Buy Low Pharmacy)
• Publix Super Markets Inc (Publix Pharmacy #0687)
• Andrew Puciaty, MD

• Community/Behavioral Health Agency in Spartanburg, SC
• Providers in Spartanburg, SC by specialty
• Community/Behavioral Health Agency in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 10, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.