Individual provider Active NPI

Shavon Jenkins

  • Professional Counselor
  • Beaufort, SC
National Provider Identifier
1992138622
Registry record updated Dec 24, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
Practice address
1905 Duke St
Suite 270
Beaufort, SC 29902-4403
Phone
(843) 255-6000
Fax
(843) 255-9406
NPI assigned
Aug 16, 2013
Last updated
Dec 24, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 24, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X
Professional Counselor 101YP2500X Primary

Addresses

Primary practice location

1905 Duke St
Suite 270
Beaufort, SC 29902-4403

Mailing address

1905 Duke St
Suite 270
Beaufort, SC 29902-4403
Phone (843) 255-6000

Other practice location 1

719 Okatie Hwy # 170
Okatie, SC 29909-3963
Phone (843) 987-7400

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
I20240509002952 SC Practitioner - Mental Health Counselor 9537500475 Reassigns benefits to 1 organization

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

Practice addresses (Care Compare)

721 N Okatie Hwy
Ridgeland, SC 29936-8276

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Beaufort Jasper Hampton Comprehensive Health Services, Inc CurrentSince May 1, 2024 Accepting new patients
From Surviving to Thriving, LLC Addiction (Substance Use Disorder) Current Accepting new patients
Beaufort Jasper Hampton Comprehensive Health Services, Inc. CurrentSince May 1, 2024 Accepting new patients
The Thriving Place Current Accepting new patients
Beaufort County Alcohol and Drug Abuse Department Past Accepting new patients
Beaufort County Alcohol & Drug Abuse Department Past Accepting new patients

Locations

719 Okatie Hwy
Okatie, SC 29909

721 Okatie Hwy
Okatie, SC 29909

721 N Okatie Hwy
#170
Ridgeland, SC 29936

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/EICIBD

Organizations & group practices 6

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1376611200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1734998400000",
    "number": "1992138622",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1905 DUKE ST",
            "address_2": "SUITE 270",
            "city": "BEAUFORT",
            "state": "SC",
            "postal_code": "299024403",
            "telephone_number": "843-255-6000",
            "fax_number": "843-255-9406"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1905 DUKE ST",
            "address_2": "SUITE 270",
            "city": "BEAUFORT",
            "state": "SC",
            "postal_code": "299024403",
            "telephone_number": "843-255-6000",
            "fax_number": "843-255-9406"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "719 Okatie Hwy # 170",
            "address_purpose": "LOCATION",
            "city": "Okatie",
            "state": "SC",
            "postal_code": "299093963",
            "country_code": "US",
            "telephone_number": "843-987-7400",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JENKINS",
        "first_name": "SHAVON",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-08-16",
        "last_updated": "2024-12-24",
        "certification_date": "2024-12-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Beaufort, SC

Sources for this page

Verify at the official NPI Registry.