Wallace Jerry Waldrop Jr., LMFT

Primary specialty

Marriage & Family TherapistTaxonomy code 106H00000X

License

6995 Issued in SC

Practice address

2917 Millwood Ave BLDG B
Columbia, SC 29205-1334

Phone

(803) 814-6218

Fax

(855) 490-9560

NPI assigned

Jun 8, 2017

Last updated

Jul 21, 2022By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in SC

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Marriage and Family Therapist

Education

Other, 2014

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Foundations Family Life Counseling and Consulting LLCGroup PAC ID 0143669465, 2 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Foundations Family Life Counseling and Consulting, LLC

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Columbia, SC
  • NPI 1235613837
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1496880000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1891224283",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2917 MILLWOOD AVE BLDG B",
            "city": "COLUMBIA",
            "state": "SC",
            "postal_code": "292051334",
            "telephone_number": "803-814-6218",
            "fax_number": "855-490-9560"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2917 MILLWOOD AVE BLDG B",
            "city": "COLUMBIA",
            "state": "SC",
            "postal_code": "292051334",
            "telephone_number": "803-814-6218",
            "fax_number": "855-490-9560"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "222 Coatbridge Dr",
            "address_purpose": "LOCATION",
            "city": "Blythewood",
            "state": "SC",
            "postal_code": "29016",
            "country_code": "US",
            "telephone_number": "910-689-6659",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WALDROP",
        "first_name": "WALLACE",
        "middle_name": "JERRY",
        "name_prefix": "Mr.",
        "name_suffix": "Jr.",
        "credential": "LMFT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2017-06-08",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "NC",
            "license": "1746",
            "primary": false
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "SC",
            "license": "6995",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Payton Walden
• Stacy McGee Walden, MS
• Stefanie Lynn Waldman
• Angela Lynn Waldrop, LMFT
• Joel S Waldrop, MD
• Erika Ann Waldsmith, PHARMD
• Meshia Q. Waleh, M.D.
• Walgreen Co (Walgreens #06136)
• Walgreen Co (Walgreens #17059)
• Walgreen Co (Walgreens #10227)

• Marriage & Family Therapist in Columbia, SC
• Providers in Columbia, SC by specialty
• Marriage & Family Therapist in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.