NPIMap

Organization Active NPI

Trinity Behavioral Care - Marion Office

  • Community/Behavioral Health Agency
  • Marion, SC
National Provider Identifier
1780745455
Registry record updated Jul 24, 2019
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 - MARION OFFICE
Practice address
1305 N Main St
Marion, SC 29571-2010
Phone
(843) 423-8292
NPI assigned
Dec 13, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 24, 2019

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

Authorized official

Name
Mr. Donny Brock
Title
Executive Director
Phone
(843) 423-8292

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) CounselorGroup: 193400000X SINGLE SPECIALTY GROUP 101YA0400X OTP-004 SC
Community/Behavioral Health Agency 251S00000X OTP-004 SC Primary

Addresses

Primary practice location

1305 N Main St
Marion, SC 29571-2010

Mailing address

PO Box 1011
Marion, SC 29571-1011
Phone (843) 423-8292

Other practice location 1

103 N. Court Street
Marion, SC 29571-1011
Phone (843) 423-8292

Other identifiers 1

IdentifierTypeStateIssuer
AD20MDMedicaidSC

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address marion@trinitybehavioralcare.org

National Provider Directory

National Provider Directory
Tax ID family
Trinity Behavioral Care - Marlboro Office6 organizations share this tax ID, including this one

Other organizations with this tax ID 5

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

Locations

103 NW Court St
Marion, SC 29571
Phone (843) 423-8292

NPI Registry JSON

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

{
    "created_epoch": "1165968000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1563926400000",
    "number": "1780745455",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1011",
            "city": "MARION",
            "state": "SC",
            "postal_code": "295711011",
            "telephone_number": "843-423-8292",
            "fax_number": "843-423-8294"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1305 N MAIN ST",
            "city": "MARION",
            "state": "SC",
            "postal_code": "295712010",
            "telephone_number": "843-423-8292"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "103 N. Court Street",
            "address_purpose": "LOCATION",
            "city": "Marion",
            "state": "SC",
            "postal_code": "295711011",
            "country_code": "US",
            "telephone_number": "843-423-8292",
            "fax_number": "843-423-8294",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "TRINITY BEHAVIORAL CARE - MARION OFFICE",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-13",
        "last_updated": "2019-07-24",
        "status": "A",
        "authorized_official_last_name": "BROCK",
        "authorized_official_first_name": "DONNY",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "843-423-8292",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  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": "AD20MD",
            "state": "SC"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "marion@trinitybehavioralcare.org",
            "affiliation": "N",
            "address_1": "1305 N Main St",
            "city": "Marion",
            "state": "SC",
            "country_code": "US",
            "postal_code": "295712010",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Marion, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 24, 2019; 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.