Individual provider Active NPI

Shakiyah Delania Demelien

  • Professional Counselor
  • Columbia, SC
National Provider Identifier
1891472510
Registry record updated Jul 4, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
8997 Issued in SC
Practice address
2638 Two Notch Rd Ste 210
Columbia, SC 29204-1454
Phone
(803) 936-1550
NPI assigned
Jul 4, 2023
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 4, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Professional CounselorGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 101YP2500X 8997 SC Primary

Addresses

Primary practice location

2638 Two Notch Rd Ste 210
Columbia, SC 29204-1454

Mailing address

2638 Two Notch Rd Ste 210
Columbia, SC 29204-1454
Phone (803) 936-1550

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20251203003465 SC Practitioner - Mental Health Counselor 4082107438 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2018
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

911 Lyttleton St
Camden, SC 29020-4412

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
8997SCMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
She'S Counseling Trichology & Consulting LLC Professional CurrentSince Jul 9, 2023 Accepting new patients
Southeastern Success Center, LLC Professional CurrentSince Oct 31, 2025 Accepting new patients

Locations

911 Lyttleton St
Camden, SC 29020
Phone (803) 713-7979

2638 Two Notch Rd
Ste 210
Columbia, SC 29204
Phone (803) 497-2274

Organizations & group practices 2

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

NPI Registry JSON

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

{
    "created_epoch": "1688428800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1688428800000",
    "number": "1891472510",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2638 TWO NOTCH RD STE 210",
            "city": "COLUMBIA",
            "state": "SC",
            "postal_code": "292041454",
            "telephone_number": "803-936-1550"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2638 TWO NOTCH RD STE 210",
            "city": "COLUMBIA",
            "state": "SC",
            "postal_code": "292041454",
            "telephone_number": "803-936-1550"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEMELIEN",
        "first_name": "SHAKIYAH",
        "middle_name": "DELANIA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-07-04",
        "last_updated": "2023-07-04",
        "certification_date": "2023-06-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Counselor, Professional",
            "state": "SC",
            "license": "8997",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Columbia, SC

Sources for this page

Verify at the official NPI Registry.