SOUTH CAROLINA MENTOR (NPI# 1972845196) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1972845196 |
| Entity Type | Organization |
| Organization Name | SOUTH CAROLINA MENTOR |
| Practice Address |
4 Carriage Ln Suite 302 Charleston SC 29407-6065 |
| Practice Telephone | 8435731905 |
| Practice Fax Number | 8435731926 |
| Mailing Telephone | 8435731905 |
| Mailing Fax Number | 8435731926 |
| Enumeration Date | 2013-03-26 |
| Last Update Date | 2013-03-26 |
| Authorized Official Name | MS. JENNIFER MARY POOLE (BEHAVIORAL CONSULTANT) |
| Authorized Official Telephone | 8435130040 |
| Authorized Official Credential | BCBA |
| Is Organization Subpart | Y |
| Parent Organization Name | THE MENTOR NETWORK |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 252Y00000X | Early Intervention Provider Agency | 1-13-12976 | SC | Agencies |
| Y | 251S00000X | Community/Behavioral Health | 1-13-12976 | SC | Agencies |
| Street Address |
4 CARRIAGE LN SUITE 302 |
| City | CHARLESTON |
| State | SC |
| Zip Code | 29407-6065 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1649249194 | Harriett Wills Grady-thomas | Social Worker | 4 Carriage Ln, Suite 108, Charleston, SC 29407-6065 | 2006-03-16 |
| 1285036673 | Krista Godek | Social Worker | 4 Carriage Ln, Charleston, SC 29407-6065 | 2014-09-17 |
| 1023451333 | Jennifer Lynn Kuhn | Behavioral Analyst | 4 Carriage Ln, Suite 302, Charleston, SC 29407-6065 | 2013-04-17 |
| 1356617781 | Calvin Jonathan Bosman LLC | Psychiatry & Neurology | 4 Carriage Ln, Suite 300-c, Charleston, SC 29407-6065 | 2012-03-29 |
| 1003181827 | Andrea Claire D'andrea | Social Worker | 4 Carriage Ln, Suite 203-b, Charleston, SC 29407-6065 | 2012-03-12 |
| 1578831939 | Carlysle Barfield, Md, LLC | Internal Medicine | 4 Carriage Ln, Suite 400 E, Charleston, SC 29407-6065 | 2011-12-13 |
| 1972822369 | Lisa Hays | Counselor | 4 Carriage Ln, Suite 302, Charleston, SC 29407-6065 | 2010-05-25 |
| 1457670093 | Ange Mary Oneal | Counselor | 4 Carriage Ln, Suite 302, Charleston, SC 29407-6065 | 2010-05-21 |
| 1619108818 | Laura Marika Charin | Behavioral Analyst | 4 Carriage Ln, Suite 302, Charleston, SC 29407-6065 | 2009-08-05 |
| 1710112198 | Larisa S Agrest | Massage Therapist | 4 Carriage Ln, Charleston, SC 29407-6065 | 2009-05-28 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1437763661 | Charleston Jaw Surgery | Oral & Maxillofacial Surgery | 846 St. Andrews Blvd., Charleston, SC 29407 | 2020-09-04 |
| 1780225128 | New Endeavors Counseling | Social Worker | 1 Carriage Lane Building E Suite 202, Charleston, SC 29407 | 2019-10-07 |
| 1770063158 | Katelyn Campbell | Psychologist | 1 Carriage Ln Ste 102, Charleston, SC 29407 | 2018-08-15 |
| 1164929956 | Anisha Gulati Md LLC | Psychiatry & Neurology | 925 Wappoo Rd., Suite F, Charleston, SC 29407 | 2018-04-09 |
| 1316459753 | David W Richardson | Dentist | 765 St. Andrews Blvd., Charleston, SC 29407 | 2017-10-25 |
| 1457874174 | Meca Mentality LLC | Chiropractor | 1106 St Andrews Blvd Suite A, Charleston, SC 29407 | 2017-07-25 |
| 1639609373 | Carolina Behavioral Specialists, LLC | Behavioral Analyst | 1529 Sam Rittenberg Blvd, Unit 1-b, Charleston, SC 29407 | 2017-06-15 |
| 1467991901 | Bernice Ladson | Registered Nurse | 75o Magnolia Road, Charleston, SC 29407 | 2017-02-16 |
| 1376991257 | Virginia Leigh Thomason | Counselor | 29 Leinbach Dr, Suite D2, Charleston, SC 29407 | 2016-06-01 |
| 1609221001 | Elinor Lee Smith | Counselor | 571 Savannah Hwy, Charleston, SC 29407 | 2016-05-04 |
| Find all providers in zip 29407 | ||||
| Taxonomy Code | 251S00000X |
| Grouping | Agencies |
| Classification | Community/Behavioral Health |
| A private or public agency usually under local government jurisdiction, responsible for assuring the delivery of community based mental health, mental retardation, substance abuse and/or behavioral health services to individuals with those disabilities. Services may range from companion care, respite, transportation, community integration, crisis intervention and stabilization, supported employment, day support, prevocational services, residential support, therapeutic and supportive consultation, environmental modifications, intensive in-home therapy and day treatment, in addition to traditional mental health and behavioral treatment. |
| Notes: Source: National Medicaid EDI HIPAA NPI Sub Work Group [1/1/2007: modified definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1215541669 | Myndspace Mental Health Education & Consulting, LLC | Community/Behavioral Health | 111 Bantry Cir, Charleston, SC 29414-8089 | 2020-09-03 |
| 1467997650 | The Underprivileged Children Foundation Inc. | Community/Behavioral Health | 716 Lee St E Ste 201, Charleston, WV 25301-1707 | 2016-12-27 |
| 1669824561 | Advantage | Community/Behavioral Health | 606 Fort Hill Dr, Charleston, WV 25314-1070 | 2016-07-05 |
| 1821458928 | Wv Institute for Spirituliaty | Community/Behavioral Health | 1601 Virginia St E, Charleston, WV 25311-2113 | 2016-03-02 |
| 1619349453 | Star, LLC | Community/Behavioral Health | 1864 Greenmore Dr, Charleston, SC 29407-3520 | 2015-10-20 |
| 1144617325 | Alliance for Change, LLC | Community/Behavioral Health | 1335 Vine St, Charleston, SC 29407-6437 | 2015-04-24 |
| 1659763001 | C&c Conversations LLC | Community/Behavioral Health | 263 King St, B, Charleston, SC 29401-1420 | 2015-02-23 |
| 1073922555 | Truliant Health Systems LLC | Community/Behavioral Health | 1535 Sam Rittenberg Blvd, Suite C, Charleston, SC 29407-4124 | 2014-08-08 |
| 1912257924 | New Horizons Therapy, LLC | Community/Behavioral Health | 2587 Ashley River Rd, Charleston, SC 29414-4613 | 2012-09-17 |
| 1376814814 | Grant and Ramsey Behavioral Health | Community/Behavioral Health | 7934 Red Birch Cir, Charleston, SC 29418-3190 | 2012-01-13 |
| Find all providers in CHARLESTON | ||||
| City | CHARLESTON |
| Zip Code | 29407 |
Please comment or provide details below to improve the information on SOUTH CAROLINA MENTOR.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.