Upstate Mental Wellness, LLC

Primary specialty

Community/Behavioral Health AgencyTaxonomy code 251S00000X

Legal business name

UPSTATE MENTAL WELLNESS, LLC

Practice address

419 SE Main St Ste 203a-2
Simpsonville, SC 29681-2673

Phone

(678) 230-0476

Fax

(833) 905-4587

NPI assigned

Jun 28, 2022

Organization subpart

No

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

Authorized official

Name

Lorene R Heuvelman-Hutchinson, LPCNPI 1720583859

Title

Owner

Phone

(678) 230-0476

Specialties & licenses 1

Addresses

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Lorene R Heuvelman-Hutchinson, MS, EDS, PSYD

  • Professional Counselor
  • Simpsonville, SC
  • NPI 1720583859
  NPD Authorized official

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

{
    "created_epoch": "1656374400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1656374400000",
    "number": "1811629926",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "419 SE MAIN ST STE 203A-2",
            "city": "SIMPSONVILLE",
            "state": "SC",
            "postal_code": "296812673",
            "telephone_number": "678-230-0476",
            "fax_number": "833-905-4587"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "419 SE MAIN ST STE 203A-2",
            "city": "SIMPSONVILLE",
            "state": "SC",
            "postal_code": "296812673",
            "telephone_number": "678-230-0476",
            "fax_number": "833-905-4587"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "UPSTATE MENTAL WELLNESS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-06-28",
        "last_updated": "2022-06-28",
        "certification_date": "2021-11-02",
        "status": "A",
        "authorized_official_last_name": "HEUVELMAN-HUTCHINSON",
        "authorized_official_first_name": "LORENE",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "678-230-0476",
        "authorized_official_credential": "LPC"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Virginia L Underwood, ADCP
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• Upstate Podiatry Group, PA
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• Community/Behavioral Health Agency in Simpsonville, SC
• Providers in Simpsonville, 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 Jun 28, 2022; 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.