NPIMap

Organization Active NPI

Living Water Mental Health Brain Treatment Center

  • Psychiatry Physician
  • Myrtle Beach, SC
National Provider Identifier
1922829365
Registry record updated Oct 6, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
Legal business name
LIVING WATER MENTAL HEALTH BRAIN TREATMENT CENTER
Practice address
1086 London St Ste B
Myrtle Beach, SC 29577-5761
Phone
(843) 839-9688
NPI assigned
Oct 18, 2024
Last updated
Oct 6, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 6, 2025

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

Authorized official

Name
Benjamin GreenzweigNPI 1740008028
Title
Executive Director
Phone
(843) 839-9688

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 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X NU Primary

Addresses

Primary practice location

1086 London St Ste B
Myrtle Beach, SC 29577-5761

Mailing address

1086 London St Ste B
Myrtle Beach, SC 29577-5761
Phone (843) 938-5913

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20250226001211 SC Part B Supplier - Clinic/Group Practice 6204356876 Receives reassigned benefits from 1 practitioner
Practice locations: Myrtle Beach, SC

National Provider Directory

National Provider Directory

Locations

1086 London St
Ste B
Myrtle Beach, SC 29577
Phone (843) 703-1027

Practitioners & affiliated clinicians

Practitioners 12

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1729209600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1759708800000",
    "number": "1922829365",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1086 LONDON ST STE B",
            "city": "MYRTLE BEACH",
            "state": "SC",
            "postal_code": "295775761",
            "telephone_number": "843-938-5913",
            "fax_number": "843-627-4617"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1086 LONDON ST STE B",
            "city": "MYRTLE BEACH",
            "state": "SC",
            "postal_code": "295775761",
            "telephone_number": "843-839-9688"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LIVING WATER MENTAL HEALTH BRAIN TREATMENT CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-10-18",
        "last_updated": "2025-10-06",
        "certification_date": "2025-10-06",
        "status": "A",
        "authorized_official_last_name": "GREENZWEIG",
        "authorized_official_first_name": "BENJAMIN",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "843-839-9688"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Myrtle Beach, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 6, 2025; 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.