Active NPI
Melissa Daciuk, PSYD, LPC-A
- Professional Counselor
- Moncks Corner, SC
National Provider Identifier
1962377853
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- 10673
- Practice address
- 1714 S Live Oak Dr
Moncks Corner, SC 29461-7215 - Phone
- (843) 879-4121
- NPI assigned
- Oct 9, 2025
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | 10673 | SC | Primary |
Addresses
Primary practice location
1714 S Live Oak Dr
Moncks Corner, SC 29461-7215
Mailing address
112 Savannah River Dr
Summerville, SC 29485-8848
Phone (704) 408-9111
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 10673 | SC | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1759968000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1759968000000",
"number": "1962377853",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "112 SAVANNAH RIVER DR",
"city": "SUMMERVILLE",
"state": "SC",
"postal_code": "294858848",
"telephone_number": "704-408-9111"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1714 S LIVE OAK DR",
"city": "MONCKS CORNER",
"state": "SC",
"postal_code": "294617215",
"telephone_number": "843-879-4121"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DACIUK",
"first_name": "MELISSA",
"name_prefix": "Dr.",
"credential": "PSYD, LPC-A",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2025-10-09",
"last_updated": "2025-10-09",
"certification_date": "2025-10-09",
"status": "A"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "SC",
"license": "10673",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Moncks Corner, SC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 9, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.