South Carolina Department of Juvenile Justice

Primary specialty

Case Management AgencyTaxonomy code 251B00000X

License

006545 Issued in SC

Legal business name

SOUTH CAROLINA DEPARTMENT OF JUVENILE JUSTICE

Practice address

5000 Broad River Rd
Columbia, SC 29212-3532

Phone

(803) 896-9029

NPI assigned

Dec 17, 2012

Last updated

Dec 17, 2012By 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

Ms. Cynthia Ann Black, LMSW

Title

Program Manager

Phone

(803) 896-9029

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1355702400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1355702400000",
    "number": "1790021970",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5000 BROAD RIVER RD",
            "city": "COLUMBIA",
            "state": "SC",
            "postal_code": "292123532",
            "telephone_number": "803-896-9029"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5000 BROAD RIVER RD",
            "city": "COLUMBIA",
            "state": "SC",
            "postal_code": "292123532",
            "telephone_number": "803-896-9029"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTH CAROLINA DEPARTMENT OF JUVENILE JUSTICE",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-12-17",
        "last_updated": "2012-12-17",
        "status": "A",
        "authorized_official_last_name": "BLACK",
        "authorized_official_first_name": "CYNTHIA",
        "authorized_official_middle_name": "ANN",
        "authorized_official_title_or_position": "PROGRAM MANAGER",
        "authorized_official_telephone_number": "803-896-9029",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "LMSW"
    },
    "taxonomies": [
        {
            "code": "251B00000X",
            "taxonomy_group": "",
            "desc": "Case Management",
            "state": "SC",
            "license": "006545",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• South Carolina Department of Education
• South Carolina Department of Juvenile Justice
• South Carolina Department of Juvenile Justice
• South Carolina Department of Juvenile Justice
• South Carolina Department of Juvenile Justice
• South Carolina Department of Mental Health
• South Carolina Department of Mental Health Accounting Office (Columbia Area Mental Health Center)
• South Carolina Department of Social Services
• South Carolina Dept of Mental Health (SCDMH Podiatry Group)
• South Carolina Dept of Mental Health (C M Tucker Jr Nursing Care Center)

• Case Management Agency in Columbia, SC
• Providers in Columbia, SC by specialty
• Case Management Agency in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 17, 2012; 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.