NPIMap

Organization Active NPI

Carolina Youth Services

  • Mental Health Counselor
  • Charleston, SC
National Provider Identifier
1790067973
Registry record updated Sep 19, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
LIC-5-11-62510 Issued in SC
Legal business name
CAROLINA YOUTH SERVICES
Practice address
2150 Spolato LN E
Charleston, SC 29406
Phone
(843) 452-0268
NPI assigned
Sep 14, 2011
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 19, 2011

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

Authorized official

Name
Ronald Witherspoon, M.A.
Title
Director
Phone
(843) 452-0268

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health CounselorGroup: 193200000X MULTI-SPECIALTY GROUP 101YM0800X LIC-5-11-62510 SC Primary

Addresses

Primary practice location

2150 Spolato LN E
Charleston, SC 29406

Mailing address

101 Tea Olive CT
Summerville, SC 29485
Phone (843) 452-0268

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1315958400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1316390400000",
    "number": "1790067973",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "101 TEA OLIVE CT",
            "city": "SUMMERVILLE",
            "state": "SC",
            "postal_code": "29485",
            "telephone_number": "843-452-0268"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2150 SPOLATO LN E",
            "city": "CHARLESTON",
            "state": "SC",
            "postal_code": "29406",
            "telephone_number": "843-452-0268"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CAROLINA YOUTH SERVICES",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-09-14",
        "last_updated": "2011-09-19",
        "status": "A",
        "authorized_official_last_name": "WITHERSPOON",
        "authorized_official_first_name": "RONALD",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "843-452-0268",
        "authorized_official_credential": "M.A."
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Mental Health",
            "state": "SC",
            "license": "LIC-5-11-62510",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Charleston, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 19, 2011; 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.