Upstate ADHD Center, LLC

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

Legal business name

UPSTATE ADHD CENTER, LLC

Practice address

300 John St Unit 5B
Greer, SC 29651-1463

Phone

(864) 714-5637

NPI assigned

Oct 11, 2021

Last updated

Oct 11, 2023By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Wanda Samake, DNP, PMHNP-BC, APRNNPI 1063561876

Title

President/Ceo

Phone

(864) 714-5637

Specialties & licenses 1

Addresses

Electronic endpoints 1

Locations

Practitioners 1

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.

• Wanda Sexton Samake, DNP, PMHNP, FNP

  • Psychiatric/Mental Health Nurse Practitioner
  • Greer, SC
  • NPI 1063561876
  NPD Authorized official

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

{
    "created_epoch": "1633910400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1696982400000",
    "number": "1972265502",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 25472",
            "city": "GREENVILLE",
            "state": "SC",
            "postal_code": "296160472",
            "telephone_number": "864-714-5637"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 JOHN ST UNIT 5B",
            "city": "GREER",
            "state": "SC",
            "postal_code": "296511463",
            "telephone_number": "864-714-5637"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "UPSTATE ADHD CENTER, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-10-11",
        "last_updated": "2023-10-11",
        "certification_date": "2023-10-11",
        "status": "A",
        "authorized_official_last_name": "SAMAKE",
        "authorized_official_first_name": "WANDA",
        "authorized_official_title_or_position": "PRESIDENT/CEO",
        "authorized_official_telephone_number": "864-714-5637",
        "authorized_official_credential": "DNP, PMHNP-BC, APRN"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "info@upstateadhdcenter.com",
            "affiliation": "N",
            "endpointDescription": "practice inbox",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "301 Halton Rd Ste F4",
            "city": "Greenville",
            "state": "SC",
            "country_code": "US",
            "postal_code": "296073496",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

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• Psychiatric/Mental Health Nurse Practitioner in Greer, SC
• Providers in Greer, SC by specialty
• Psychiatric/Mental Health Nurse Practitioner in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 11, 2023; 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.