NPIMap

Organization Active NPI

Ernest E. Kennedy Center

  • Professional Counselor
  • Moncks Corner, SC
National Provider Identifier
1750406476
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
3396 Issued in SC
Legal business name
ERNEST E. KENNEDY CENTER
Practice address
306 Airport Dr
Moncks Corner, SC 29461-2629
Phone
(843) 719-3000
Fax
(843) 719-3025
NPI assigned
Mar 20, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Mr. Jerome Tilghman Jr., LPC
Title
Director of Clinical Services
Phone
(843) 719-3000

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Professional CounselorGroup: 193400000X SINGLE SPECIALTY GROUP 101YP2500X 3396 SC Primary

Addresses

Primary practice location

306 Airport Dr
Moncks Corner, SC 29461-2629

Mailing address

306 Airport Dr
Moncks Corner, SC 29461-2629
Phone (843) 719-3000

National Provider Directory

National Provider Directory
Tax ID family
The Ernest E Kennedy Center4 organizations share this tax ID, including this one

Other organizations with this tax ID 3

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

NPI Registry JSON

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

{
    "created_epoch": "1174348800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1750406476",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "306 AIRPORT DR",
            "city": "MONCKS CORNER",
            "state": "SC",
            "postal_code": "294612629",
            "telephone_number": "843-719-3000",
            "fax_number": "843-719-3025"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "306 AIRPORT DR",
            "city": "MONCKS CORNER",
            "state": "SC",
            "postal_code": "294612629",
            "telephone_number": "843-719-3000",
            "fax_number": "843-719-3025"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ERNEST E. KENNEDY CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-20",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "TILGHMAN",
        "authorized_official_first_name": "JEROME",
        "authorized_official_title_or_position": "DIRECTOR OF CLINICAL SERVICES",
        "authorized_official_telephone_number": "843-719-3000",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_name_suffix": "Jr.",
        "authorized_official_credential": "LPC"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Counselor, Professional",
            "state": "SC",
            "license": "3396",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Moncks Corner, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.