JEREMY CRADDOCK (NPI# 1306246251) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1306246251 |
| Entity Type | Individual |
| Full Name | JEREMY CRADDOCK |
| Practice Address |
301a Palmetto Park Blvd Lexington SC 29072-7872 |
| Mailing Address |
34 Woodcross Dr 210 Columbia SC 29212-2355 |
| Practice Telephone | 8033593545 |
| Enumeration Date | 2014-08-28 |
| Last Update Date | 2014-08-28 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 101YM0800X |
Counselor Specialization: Mental Health |
5624 | SC | Behavioral Health & Social Service Providers |
| Street Address |
301A PALMETTO PARK BLVD |
| City | LEXINGTON |
| State | SC |
| Zip Code | 29072-7872 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1033135553 | Bonnie Watts Mooney | Social Worker | 301a Palmetto Park Blvd, Lexington, SC 29072-7872 | 2006-07-15 |
| 1447776679 | Amber Nickerson | Social Worker | 301a Palmetto Park Blvd, Lexington, SC 29072-7872 | 2017-08-18 |
| 1861892846 | Trisha O'toole | Registered Nurse | 301a Palmetto Park Blvd, Lexington, SC 29072-7872 | 2014-08-27 |
| 1407278351 | Ellen Gold | Registered Nurse | 301a Palmetto Park Blvd, Lexington, SC 29072-7872 | 2014-01-13 |
| 1164856274 | Barbara Ann Kramer | Registered Nurse | 301a Palmetto Park Blvd, Lexington, SC 29072-7872 | 2013-08-26 |
| 1346539756 | Sandra R Schmidt | Counselor | 301a Palmetto Park Blvd, Lexington, SC 29072-7872 | 2011-04-06 |
| 1326148453 | Queen J Flowers | Nurse Practitioner | 301a Palmetto Park Blvd, Lexington, SC 29072-7872 | 2006-09-25 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1700484821 | Grace Physicians Services | Clinic/Center | 1483 Old Cherokee Road, Lexington, SC 29072 | 2020-10-12 |
| 1750995007 | Trinity Health and Wellness | Clinic/Center | 1483 Old Cherokee Rd, Lexington, SC 29072 | 2020-09-03 |
| 1730727629 | Erika Watts | Occupational Therapist | 100 Tarrar Springs Road, Sped, Lexington, SC 29072 | 2019-12-11 |
| 1194380600 | Lexington County Health Services District, Inc. | Clinic/Center | 154 Saluda Pointe Ct, Lexington, SC 29072 | 2019-05-09 |
| 1962973768 | William R. Key | Counselor | Lexington Community Mental Health Center, 301 Palmetto Park Boulevard, Lexington, SC 29072 | 2018-12-06 |
| 1639651961 | Lindsey Terry | Social Worker | 108 Palmetto Pk. Boulveard, Suite D, Lexington, SC 29072 | 2018-09-04 |
| 1922594126 | Dental Professional of South Carolina, P.C. | Dentist | 2448 Augusta Hwy, Lexington, SC 29072 | 2018-07-11 |
| 1598251605 | Lynn Marceline Beckett-lowe | Nurse Practitioner | 124 Pink Camellia Lane, Lexington, SC 29072 | 2018-07-02 |
| 1083120620 | Diana Reiss | Counselor | 714 S Lake Drive, 120, Lexington, SC 29072 | 2017-12-19 |
| 1649781857 | Constance Jean Lynch | Occupational Therapist | 800 North Lake Boulevard, Lexington, SC 29072 | 2017-10-14 |
| Find all providers in zip 29072 | ||||
| Taxonomy Code | 101YM0800X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Counselor |
| Specialization | Mental Health |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1790383693 | Bowlight Partners LLC | Counselor | 32 Edgewood Rd, Lexington, MA 02420-3500 | 2020-10-13 |
| 1306450739 | Rebeca Griffith | Counselor | 304 Grey Oaks Ct, Lexington, SC 29072-7418 | 2020-09-02 |
| 1164034294 | Ashlyn Brooke Bordelon | Counselor | 113 Ivy Hill Ct, Lexington, SC 29072-8054 | 2020-08-19 |
| 1720698897 | Tracy Mae Springate | Counselor | 750 Shaker Dr Apt 202, Lexington, KY 40504-3725 | 2020-08-04 |
| 1760090724 | Statera Counseling, LLC | Counselor | 281 Governors Grant Blvd, Lexington, SC 29072-8826 | 2020-07-16 |
| 1396361374 | Courtney Scott | Counselor | 1666 Massachusetts Ave Fl 2, Lexington, MA 02420-5313 | 2020-06-24 |
| 1144846684 | A Better Way | Counselor | 366 Waller Ave Ste 213, Lexington, KY 40504-2921 | 2020-06-21 |
| 1366067381 | Kadie Ann Bourgoin | Counselor | 230 White Oleander Dr, Lexington, SC 29072-7037 | 2020-06-15 |
| 1629690672 | Summit Counseling Center | Counselor | 145 Burt Rd Ste 19, Lexington, KY 40503-2401 | 2020-05-13 |
| 1083240709 | Seung Hee Oh | Counselor | 7 Stedman Rd Apt 301, Lexington, MA 02421-7133 | 2020-03-13 |
| Find all providers in LEXINGTON | ||||
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| 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.