The Calvary Experience

Primary specialty

Adolescent and Children Mental Health Clinic/CenterTaxonomy code 261QM0855X

Legal business name

THE CALVARY EXPERIENCE

Practice address

2810 Ashley Phosphate Rd Ste B8
N Charleston, SC 29418-6406

Phone

(843) 297-4630

NPI assigned

Jun 21, 2019

Last updated

Jun 21, 2019By 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

Cassandra WilliamsNPI 1801452925

Title

Owner

Phone

(843) 834-6038

Specialties & licenses 3

Addresses

Other identifiers 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.

• Cassandra La'Veda Williams, D.MIN.

  • Behavior Technician
  • Ewa Beach, HI
  • NPI 1801452925
  NPD (past) Authorized official

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

{
    "created_epoch": "1561075200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1561075200000",
    "number": "1982265823",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2810 ASHLEY PHOSPHATE RD STE B8",
            "city": "N CHARLESTON",
            "state": "SC",
            "postal_code": "294186406",
            "telephone_number": "843-297-4630"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2810 ASHLEY PHOSPHATE RD STE B8",
            "city": "N CHARLESTON",
            "state": "SC",
            "postal_code": "294186406",
            "telephone_number": "843-297-4630"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THE CALVARY EXPERIENCE",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-06-21",
        "last_updated": "2019-06-21",
        "status": "A",
        "authorized_official_last_name": "WILLIAMS",
        "authorized_official_first_name": "CASSANDRA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "843-834-6038"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QM0850X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adult Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QM0855X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adolescent and Children Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1801452925",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Supplemental Health Care
• Stephen Tanner
• Ann Taylor, M.D.
• The Balance Mobility & Dizziness Center
• The Body Chiropractic
• Christine C Thompson, MD
• Top Assistant Homecare
• Tranquility Spa, LLC
• Trident Pain Center
• Trident Pain Center LLC

• Adolescent and Children Mental Health Clinic/Center in N Charleston, SC
• Providers in N Charleston, SC by specialty
• Adolescent and Children Mental Health Clinic/Center in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 21, 2019; 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.