Individual provider Active NPI

Lisa Renee Puryear, LPC

  • Mental Health Counselor
  • Columbia, SC
National Provider Identifier
1922455195
Registry record updated Feb 18, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
6824 Issued in SC
Practice address
2212 Devine St
Columbia, SC 29205-2402
Phone
(803) 573-4463
NPI assigned
May 18, 2016
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 18, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X 209 SC
Mental Health Counselor 101YM0800X 6824 SC Primary

Addresses

Primary practice location

2212 Devine St
Columbia, SC 29205-2402

Mailing address

2417 Craig Rd
Columbia, SC 29204-2632
Phone (803) 403-7891

Other practice location 1

5110 Fairfield Rd
Columbia, SC 29203-4323
Phone (803) 893-7019

Other practice location 2

905 State St
Cayce, SC 29033-4318
Phone (803) 832-4383

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
I20250411003397 SC Practitioner - Mental Health Counselor 0749572790 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Oak Street Health Physicians Group of South Carolina LLCGroup PAC ID 3375959075, 31 clinicians

Practice addresses (Care Compare)

5110 Fairfield Rd
Columbia, SC 29203-4323
Phone (803) 893-7019

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
6364SCMDCounselor
209SCMDRegistered Dietitian
6824SCMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Oak Street Health Physicians Group of South Carolina, LLC CurrentSince Mar 31, 2025 Accepting new patients
Nova Physician Group PLLC CurrentSince Mar 31, 2025 Accepting new patients
Positive Pathways Counseling Center LLC Addiction (Substance Use Disorder) CurrentSince Sep 15, 2024 Accepting new patients

Locations

905 State St
Cayce, SC 29033
Phone (803) 832-4383

5110 Fairfield Rd
Columbia, SC 29203
Phone (803) 691-5650

6119 White Horse Rd
Ste 14
Greenville, SC 29611
Phone (864) 614-7001

Organizations & group practices 3

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": "1463529600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1739836800000",
    "number": "1922455195",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2417 CRAIG RD",
            "city": "COLUMBIA",
            "state": "SC",
            "postal_code": "292042632",
            "telephone_number": "803-403-7891"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2212 DEVINE ST",
            "city": "COLUMBIA",
            "state": "SC",
            "postal_code": "292052402",
            "telephone_number": "803-573-4463"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5110 Fairfield Rd",
            "address_purpose": "LOCATION",
            "city": "Columbia",
            "state": "SC",
            "postal_code": "292034323",
            "country_code": "US",
            "telephone_number": "803-893-7019",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "905 State St",
            "address_purpose": "LOCATION",
            "city": "Cayce",
            "state": "SC",
            "postal_code": "290334318",
            "country_code": "US",
            "telephone_number": "803-832-4383",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PURYEAR",
        "first_name": "LISA",
        "middle_name": "RENEE",
        "name_prefix": "Mrs.",
        "credential": "LPC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-05-18",
        "last_updated": "2025-02-18",
        "certification_date": "2025-02-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "SC",
            "license": "209",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "SC",
            "license": "6824",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Columbia, SC

Sources for this page

Verify at the official NPI Registry.