Individual provider Active NPI

Calvin A. Edmundson, LPC

  • Professional Counselor
  • Columbia, SC
National Provider Identifier
1962014175
Registry record updated Dec 22, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
7568 Issued in SC
Practice address
4605 Monticello Rd Ste 3
Columbia, SC 29203-4156
Phone
(803) 754-0151
Fax
(803) 691-1778
NPI assigned
Aug 19, 2020
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 22, 2025

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 7568 SC Primary

Addresses

Primary practice location

4605 Monticello Rd Ste 3
Columbia, SC 29203-4156

Mailing address

169 Laurelhurst Ave
Columbia, SC 29210-3825
Phone (803) 733-5969

Other practice location 1

391 Serpentine Dr Ste 400
Spartanburg, SC 29303-3081
Phone (864) 560-7517

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
I20240710005282 SC Practitioner - Mental Health Counselor 0840735130 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Eau Claire Cooperative Health Center, Inc. 45 clinicians
Spartanburg Medical Center 1,060 clinicians

Practice addresses (Care Compare)

1228 Harden St
Columbia, SC 29204-1800

391 Serpentine Dr
Suite 400
Spartanburg, SC 29303-3081
Phone (864) 560-7517

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Spartanburg Medical Center CurrentSince Nov 22, 2025 Accepting new patients
Eau Claire Cooperative Health Center, Inc. CurrentSince Apr 7, 2024 Accepting new patients
Spartanburg Medical Center CurrentSince Nov 22, 2025 Accepting new patients
Eau Claire Cooperative Health Center ,Inc. CurrentSince Apr 7, 2024 Accepting new patients
Pediatrics of Newberry, LLC PastSince Aug 23, 2020 Accepting new patients

Locations

4605 Monticello Rd
Columbia, SC 29203
Phone (803) 252-7001

169 Laurelhurst Ave
Columbia, SC 29210
Phone (803) 730-0742

4605 Monticello Rd
Ste 3
Columbia, SC 29203
Phone (803) 754-0151

4605 Monticello Rd
Ste 1
Columbia, SC 29203
Phone (803) 252-7001

2755 S Highway 14
Ste 1200D
Greer, SC 29650
Phone (864) 849-9333

391 Serpentine Dr
Ste 400
Spartanburg, SC 29303
Phone (864) 560-7517

Organizations & group practices 22

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.

View all 22

NPI Registry JSON

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

{
    "created_epoch": "1597795200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1766361600000",
    "number": "1962014175",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "169 LAURELHURST AVE",
            "city": "COLUMBIA",
            "state": "SC",
            "postal_code": "292103825",
            "telephone_number": "803-733-5969",
            "fax_number": "803-753-5591"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4605 MONTICELLO RD STE 3",
            "city": "COLUMBIA",
            "state": "SC",
            "postal_code": "292034156",
            "telephone_number": "803-754-0151",
            "fax_number": "803-691-1778"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "391 Serpentine Dr Ste 400",
            "address_purpose": "LOCATION",
            "city": "Spartanburg",
            "state": "SC",
            "postal_code": "293033081",
            "country_code": "US",
            "telephone_number": "864-560-7517",
            "fax_number": "864-560-7520",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "EDMUNDSON",
        "first_name": "CALVIN",
        "middle_name": "A.",
        "credential": "LPC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-08-19",
        "last_updated": "2025-12-22",
        "certification_date": "2025-12-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "SC",
            "license": "7568",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Columbia, SC

Sources for this page

Verify at the official NPI Registry.