Individual provider Active NPI

Shatiera C Lee

  • Professional Counselor
  • Columbia, SC
National Provider Identifier
1902675812
Registry record updated Dec 20, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
8725 Issued in SC
Practice address
220 Stoneridge Dr Ste 302
Columbia, SC 29210-8018
Phone
(803) 779-2777
NPI assigned
Dec 20, 2023
Last updated
Dec 20, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 20, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X 8725 SC Primary

Addresses

Primary practice location

220 Stoneridge Dr Ste 302
Columbia, SC 29210-8018

Mailing address

1510 Saint Andrews Rd Apt 307
Columbia, SC 29210-5936

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
I20260528000698 SC Practitioner - Mental Health Counselor 5193295483 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2023
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

220 Stoneridge Dr
Suite 302
Columbia, SC 29210-8018

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
8725SCMDSocial Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Agape Counseling and Training Services Inc. CurrentSince May 5, 2026 Accepting new patients

Locations

220 Stoneridge Dr
Ste 302
Columbia, SC 29210
Phone (803) 779-2777

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1703030400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1703030400000",
    "number": "1902675812",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1510 SAINT ANDREWS RD APT 307",
            "city": "COLUMBIA",
            "state": "SC",
            "postal_code": "292105936"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "220 STONERIDGE DR STE 302",
            "city": "COLUMBIA",
            "state": "SC",
            "postal_code": "292108018",
            "telephone_number": "803-779-2777"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEE",
        "first_name": "SHATIERA",
        "middle_name": "C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-12-20",
        "last_updated": "2023-12-20",
        "certification_date": "2023-12-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "SC",
            "license": "8725",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Columbia, SC

Sources for this page

Verify at the official NPI Registry.