PALMETTO CENTER FOR CHANGE, LLC (NPI# 1427432046) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1427432046 |
| Entity Type | Organization |
| Organization Name | PALMETTO CENTER FOR CHANGE, LLC |
| Practice Address |
1905 Sunset Blvd Ste C West Columbia SC 29169-5955 |
| Practice Telephone | 8038510902 |
| Practice Fax Number | 8038517192 |
| Mailing Telephone | 8038510902 |
| Mailing Fax Number | 8038517192 |
| Enumeration Date | 2015-07-14 |
| Last Update Date | 2019-02-05 |
| Authorized Official Name | CAROL E. O. ANDERSON (OWNER) |
| Authorized Official Telephone | 8038510902 |
| Authorized Official Credential | LISW-CP |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1041C0700X |
Social Worker Specialization: Clinical |
6960 | SC | Behavioral Health & Social Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| SC | DOL | 616366600 | 01 |
| SC | MOLINA | QMP000002409221 | 01 |
| SC | SELECT HEALTH | 612752000 | 01 |
| SC | MEDICARE PTAN | Q371020281 | 01 |
| SC | SW1077 | 05 | |
| SC | GP7051 | 05 |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 2318 Sunset Blvd # A2, West Columbia, SC 291694716 | 8038510902 | 8038517192 |
| Street Address |
1905 SUNSET BLVD STE C |
| City | WEST COLUMBIA |
| State | SC |
| Zip Code | 29169-5955 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1013297928 | Carol E. O. Anderson | Social Worker | 1905 Sunset Blvd Ste C, West Columbia, SC 29169 | 2011-08-23 |
| 1568007888 | Insight Counseling & Consulting, LLC | Counselor | 1905 Sunset Blvd Ste C, West Columbia, SC 29169-5955 | 2019-11-11 |
| 1699286898 | Jenny Rosenberg Bouknight | Counselor | 1905 Sunset Blvd Ste C, West Columbia, SC 29169-5955 | 2017-10-16 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1457960726 | Jerry Scott Oreilly | Physical Therapy Assistant | 100 Dreher Rd, Suite 100, West Columbia, SC 29169 | 2020-07-23 |
| 1134759921 | A&m Medical, LLC | Durable Medical Equipment & Medical Supplies | 1053 Sunset Boulevard, West Columbia, SC 29169 | 2020-01-21 |
| 1750946067 | First Physical Therapy, LLC | Clinic/Center | 100 Dreher Rd., Suite 100, West Columbia, SC 29169 | 2019-05-02 |
| 1295217545 | Tynaka Kwans Wilson | Nurse Practitioner | Sc House Calls Inc, 1053 Center Street, West Columbia, SC 29169 | 2018-09-04 |
| 1588183826 | Kimberly Jane Jennings | Registered Nurse | 1052 Center Street, Sc House Calls Inc, West Columbia, SC 29169 | 2017-09-19 |
| 1164943213 | Jacob Luke Wayland | Emergency Medicine | Lexington Medical Center-emergency Medicine Dept, 2720 Sunset Blvd, West Columbia, SC 29169 | 2017-06-29 |
| 1740721232 | Heather Detwiler | Physical Therapy Assistant | 2705 Leaphart Rd., Carolina Gardens, West Columbia, SC 29169 | 2017-03-16 |
| 1588110761 | Virginia I Hall | Nurse Practitioner | 2720 Susnet Blvd, West Columbia, SC 29169 | 2016-08-29 |
| 1215395744 | Stacey Khalifa | Social Worker | 160 Medical Cir Fl 1, West Columbia, SC 29169 | 2016-01-28 |
| 1407252331 | Sandy Frye Boone | Counselor | 2318 Sunset Blvd # 2a, West Columbia, SC 29169 | 2014-11-04 |
| Find all providers in zip 29169 | ||||
| Taxonomy Code | 1041C0700X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Social Worker |
| Specialization | Clinical |
| A social worker who holds a master’s or doctoral degree in social work from an accredited school of social work in addition to at least two years of post-master’s supervised experience in a clinical setting. The social worker must be licensed, certified, or registered at the clinical level in the jurisdiction of practice. A clinical social worker provides direct services, including interventions focused on interpersonal interactions, intrapsychic dynamics, and life management issues. Clinical social work services are based on bio-psychosocial perspectives. Services consist of assessment, diagnosis, treatment (including psychotherapy and counseling), client-centered advocacy, consultation, evaluation, and prevention of mental illness, emotional, or behavioral disturbances. |
| Notes: Source: National Association of Social Workers, 2008 [7/1/2009: definition modified] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1972125284 | Margaret Hollifield | Social Worker | 1400 B Ave, West Columbia, SC 29169-6102 | 2020-05-08 |
| 1215395744 | Stacey Khalifa | Social Worker | 160 Medical Cir Fl 1, West Columbia, SC 29169 | 2016-01-28 |
| 1083019913 | Samuel Bethel | Social Worker | 206 S Lucas St Apt A, West Columbia, SC 29169-7200 | 2014-11-04 |
| 1013297928 | Carol E. O. Anderson | Social Worker | 1905 Sunset Blvd Ste C, West Columbia, SC 29169 | 2011-08-23 |
| 1669599544 | Charles Anthony Abercrombie | Social Worker | 1716 Chimney Swift Ln, West Columbia, SC 29169-5418 | 2007-03-23 |
| 1952438376 | Mt.hebron Pastoral Counseling Service | Social Worker | 3050 Leaphart Rd, West Columbia, SC 29169-3000 | 2007-02-27 |
| 1235180654 | Stephanie F. Greene | Social Worker | 2999 Sunset Blvd, Suite 100, West Columbia, SC 29169-3496 | 2006-05-12 |
| 1578536066 | Tammie Fowles | Social Worker | 803 Charleston Hwy, West Columbia, SC 29169-6110 | 2006-02-07 |
| 1538776364 | Megan Susanne Peeples | Social Worker | 4788 Platt Springs Rd, West Columbia, SC 29170-1028 | 2020-09-25 |
| 1407402191 | Rachel Kelley | Social Worker | 2858 Sunset Blvd, West Columbia, SC 29169-3420 | 2019-08-17 |
| Find all providers in WEST COLUMBIA | ||||
| City | WEST COLUMBIA |
| Zip Code | 29169 |
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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.