PIEDMONT PSYCHIATRIC SERVICE PA (NPI# 1164481867) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1164481867 |
| Entity Type | Organization |
| Organization Name | PIEDMONT PSYCHIATRIC SERVICE PA |
| Practice Address |
2094 Woodruff Rd Greenville SC 29607-5939 |
| Practice Telephone | 8646769211 |
| Practice Fax Number | 8646769432 |
| Mailing Telephone | 8646769211 |
| Mailing Fax Number | 8646769432 |
| Enumeration Date | 2006-03-21 |
| Last Update Date | 2011-02-03 |
| Authorized Official Name | DR. TONY GOODBAR (PHYSICIAN) |
| Authorized Official Telephone | 8646769211 |
| Authorized Official Credential | M. D. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QM0850X |
Clinic/Center Specialization: Adult Mental Health |
14711 | SC | Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| SC | GP2107 | 05 |
| Street Address |
2094 WOODRUFF RD |
| City | GREENVILLE |
| State | SC |
| Zip Code | 29607-5939 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1487988838 | Joseph A Friddle | Physician Assistant | 2094 Woodruff Rd, Greenville, SC 29607-5939 | 2009-10-01 |
| 1982645016 | Lisa L Wischhusen | Specialist | 2094 Woodruff Rd, Greenville, SC 29607-5939 | 2006-06-09 |
| 1306884630 | Mary L. Shults | Counselor | 2094 Woodruff Rd, Greenville, SC 29607-5939 | 2006-06-02 |
| 1588602734 | Tony R Goodbar | Specialist | 2094 Woodruff Rd, Greenville, SC 29607-5939 | 2006-06-02 |
| 1932147188 | Jeffrey K Smith | Specialist | 2094 Woodruff Rd, Greenville, SC 29607-5939 | 2006-06-02 |
| 1801834072 | Carol Rentz Mitchell | Counselor | 2094 Woodruff Rd, Greenville, SC 29607-5939 | 2006-06-02 |
| 1669410841 | Michael D Smith | Counselor | 2094 Woodruff Rd, Greenville, SC 29607-5939 | 2006-06-02 |
| 1720026057 | John P Taylor | Specialist | 2094 Woodruff Rd, Greenville, SC 29607-5939 | 2006-06-02 |
| 1477500882 | James M Harbin | Counselor | 2094 Woodruff Rd, Greenville, SC 29607 | 2006-05-30 |
| 1205883618 | Albert C Bennett | Counselor | 2094 Woodruff Rd, Greenville, SC 29607-5939 | 2006-05-30 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1245846138 | Personalized Home Care Services | Technician | 1200 Woodruff Rd A3 Ste 150, Greenville, SC 29607 | 2020-09-16 |
| 1396361960 | Complete Homecare of America, Inc. | In Home Supportive Care | 128 Millport Circle, Suite 200, Greenville, SC 29607 | 2020-06-19 |
| 1275175093 | Carrie Laxton Ballenger | Nurse Practitioner | 2094 Woodruff Road, Greenville, SC 29607 | 2019-10-14 |
| 1861047037 | Susannah Long | Marriage & Family Therapist | 109 Laurens Road, Building 4 Ste D, Greenville, SC 29607 | 2019-08-05 |
| 1043872369 | Cheryl Craig Rosemond | Case Manager/Care Coordinator | 5 Century Drive, Suite 130, Greenville, SC 29607 | 2019-07-08 |
| 1457916561 | After Hours Chiropractic LLC | Chiropractor | 1200 Woodruff Rd Blg A-3, Simpsonville, SC 29607 | 2019-05-03 |
| 1952865289 | Orthodontic Specialists of Carolina, PC | Dentist | 611 Haywood Road, Greenville, SC 29607 | 2019-01-31 |
| 1124502307 | Martha Irby | Home Health Aide | 2320 E North St Rr 107, Greenville, SC 29607 | 2018-09-24 |
| 1780164541 | Suval Psychiatric Services, Pa | Clinic/Center | 33 Market Point Dr Ste 2023, Greenville, SC 29607 | 2018-08-20 |
| 1083113963 | Caroline Graham | Nurse Practitioner | 850 S Pleasantburg Dr, Greenville, SC 29607 | 2018-02-06 |
| Find all providers in zip 29607 | ||||
| Taxonomy Code | 261QM0850X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Adult Mental Health |
| An entity, facility, or distinct part of a facility providing diagnostic, treatment, and prescriptive services related to mental and behavioral disorders in adults. |
| Notes: [7/1/2003: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1013514587 | Lisa Johnson Reid | Clinic/Center | 3491 Evans St Ste B, Greenville, NC 27834-4534 | 2020-10-07 |
| 1497363527 | Lumin Center, LLC | Clinic/Center | 306a Mills Ave, Greenville, SC 29605-4022 | 2020-07-15 |
| 1407497803 | Jouney Counseling, LLC | Clinic/Center | 439 Congaree Rd Ste 6, Greenville, SC 29607-2868 | 2019-10-07 |
| 1366004848 | Vitality Clinical Services, Pllc | Clinic/Center | 300 E Arlington Blvd Ofc 9, Greenville, NC 27858-5037 | 2019-07-03 |
| 1023304748 | Genesis Inc. of Nc | Clinic/Center | 609 Country Club Dr, Suite D, Greenville, NC 27834-6208 | 2011-06-21 |
| 1235127572 | Sandra Bunch Walton | Clinic/Center | 1990 Allen Rd, Suite B, Greenville, NC 27834-0058 | 2005-10-11 |
| 1598234056 | Samaritan Health Care, PC | Clinic/Center | 811 E Kent Rd, Greenville, MI 48838-9791 | 2018-11-14 |
| 1861979270 | Peri Counseling, Pllc | Clinic/Center | 1310 E Arlington Blvd Ste A, Greenville, NC 27858-9976 | 2018-07-27 |
| 1205209608 | Good Samaritan Clinic of Washington County Inc. | Clinic/Center | 2524 E Alexander St, Greenville, MS 38703-3330 | 2015-11-06 |
| 1598901159 | Walyko Psychological Associates, Inc. | Clinic/Center | 3485 S Evans St, Greenville, NC 27834-4532 | 2008-12-31 |
| Find all providers in GREENVILLE | ||||
| City | GREENVILLE |
| Zip Code | 29607 |
Please comment or provide details below to improve the information on PIEDMONT PSYCHIATRIC SERVICE PA.
| 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.