Kenneth W Phelps, PHD, LMFT

Primary specialty

Marriage & Family TherapistTaxonomy code 106H00000X

License

4520 Issued in SC

Practice address

3555 Harden Street Ext
15 Medical Park, Suite 141
Columbia, SC 29203-6894

Phone

(803) 434-4221

Fax

(803) 434-4351

NPI assigned

Jul 7, 2009

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Philosophy

State licenses

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

{
    "created_epoch": "1246924800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1289520000000",
    "number": "1942439302",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3555 HARDEN STREET EXT",
            "address_2": "15 MEDICAL PARK, SUITE 141",
            "city": "COLUMBIA",
            "state": "SC",
            "postal_code": "292036894",
            "telephone_number": "803-434-4221",
            "fax_number": "803-434-4351"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3555 HARDEN STREET EXT",
            "address_2": "15 MEDICAL PARK, SUITE 141",
            "city": "COLUMBIA",
            "state": "SC",
            "postal_code": "292036894",
            "telephone_number": "803-434-4221",
            "fax_number": "803-434-4351"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PHELPS",
        "first_name": "KENNETH",
        "middle_name": "W",
        "name_prefix": "Dr.",
        "credential": "PHD, LMFT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-07-07",
        "last_updated": "2010-11-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "SC",
            "license": "4520",
            "primary": true
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "NC",
            "license": "1309",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "LT1001",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Nathaniel Troy Pharis, DHSC, LPCS, LACS
• Quinessa Cook Pharr, MA, CCC-SLP
• Kendall Phelps-Polirer
• Benjamin J. Phelps, D.O.
• Heather Bratt Phelps, LISW-CP, RYT-200
• Lahartha Schretta Phelps
• Lauren Lynn Phelps
• Phenomenal Hair Replacement Services LLC
• Phenomenal Home Health Care LLP
• Philippians 4:13 Home Health & Medical Express, LLC

• Marriage & Family Therapist in Columbia, SC
• Providers in Columbia, SC by specialty
• Marriage & Family Therapist in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 12, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.