NPIMap

Organization Active NPI

Kaleidoscope Counseling

  • Community/Behavioral Health Agency
  • Duncan, SC
National Provider Identifier
1922542950
Registry record updated Aug 6, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Behavioral Health AgencyTaxonomy code 251S00000X
Legal business name
KALEIDOSCOPE COUNSELING
Practice address
2153 E Main St
C14 #385
Duncan, SC 29334-8724
Phone
(864) 590-1077
NPI assigned
Dec 9, 2016
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 6, 2020

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

Authorized official

Name
Ms. Melissa Leigh Shorey, LISW-CP/SNPI 1093068041
Title
Owner/Provider
Phone
(864) 485-2500

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Marriage & Family TherapistGroup: 193400000X SINGLE SPECIALTY GROUP 106H00000X 4594 SC
Community/Behavioral Health Agency 251S00000X Primary

Addresses

Primary practice location

2153 E Main St
C14 #385
Duncan, SC 29334-8724

Mailing address

7280 Reidville Rd
Suite B
Woodruff, SC 29388-9792
Phone (864) 485-2500

Other identifiers 1

IdentifierTypeStateIssuer
SW1141MedicaidSC

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SC

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20200826003890 SC Part B Supplier - Clinic/Group Practice 9931526688 Receives reassigned benefits from 3 practitioners
Practice locations: Spartanburg, SC; Woodruff, SC

National Provider Directory

National Provider Directory

Locations

2153 E Main St
Ste C14
Duncan, SC 29334
Phone (864) 590-1077

127 Metro Dr
Spartanburg, SC 29303
Phone (864) 219-2333

7280 Reidville Rd
Ste B
Woodruff, SC 29388
Phone (864) 485-2500

Practitioners & affiliated clinicians

Practitioners 7

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

NPI Registry JSON

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

{
    "created_epoch": "1481241600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1596672000000",
    "number": "1922542950",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7280 REIDVILLE RD",
            "address_2": "SUITE B",
            "city": "WOODRUFF",
            "state": "SC",
            "postal_code": "293889792",
            "telephone_number": "864-485-2500"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2153 E MAIN ST",
            "address_2": "C14 #385",
            "city": "DUNCAN",
            "state": "SC",
            "postal_code": "293348724",
            "telephone_number": "864-590-1077"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KALEIDOSCOPE COUNSELING",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-12-09",
        "last_updated": "2020-08-06",
        "certification_date": "2020-08-06",
        "status": "A",
        "authorized_official_last_name": "SHOREY",
        "authorized_official_first_name": "MELISSA",
        "authorized_official_middle_name": "LEIGH",
        "authorized_official_title_or_position": "OWNER/PROVIDER",
        "authorized_official_telephone_number": "864-485-2500",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "LISW-CP/S"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Marriage & Family Therapist",
            "state": "SC",
            "license": "4594",
            "primary": false
        },
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "SW1141",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Duncan, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 6, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.