DEPARTMENT OF JUVENILE JUSTICE (NPI# 1619212917) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1619212917 |
| Entity Type | Organization |
| Organization Name | DEPARTMENT OF JUVENILE JUSTICE |
| Other Organization Name | SOUTH CAROLINA STATE GOVERNMENT |
| Practice Address |
1725 Shivers Rd Columbia SC 29210-5413 |
| Mailing Address |
11 Bradford Knoll Ct Columbia SC 29223-7142 |
| Practice Telephone | 8068965695 |
| Mailing Telephone | 8037888911 |
| Enumeration Date | 2012-11-28 |
| Last Update Date | 2012-12-03 |
| Authorized Official Name | MS. DEBORAH BENNETT-YORK (SOCIAL WORKER) |
| Authorized Official Telephone | 8037888911 |
| Authorized Official Credential | LISW-CP, BCD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 251S00000X | Community/Behavioral Health | 4663 | SC | Agencies |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| SC | LICENSED BY THE BOARD OF SOCIAL WORK EXAMINERS | 4663 | 01 |
| SC | AMERICAN BOARD OF EXAMINERS OF CLINICAL SOCIAL WORKERS | 29832 | 01 |
| Other Name | Type Code |
|---|---|
| South Carolina State Government | Other Name - Individual/Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1255768024 | Department of Juvenile Justice | Nursing Facility/Intermediate Care Facility | 450 Crescent Dr, Gainesville, GA 30501-5079 | 2013-10-10 |
| 1588900484 | Department of Juvenile Justice | Community/Behavioral Health | 5000 Broad River Rd, Columbia, SC 29212-3532 | 2012-12-20 |
| 1891031175 | Department of Juvenile Justice | Case Management | 4900 Broad River Rd, Columbia, SC 29212-3531 | 2012-12-14 |
| Street Address |
1725 SHIVERS RD |
| City | COLUMBIA |
| State | SC |
| Zip Code | 29210-5413 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1639415920 | Individual | Residential Treatment Facility, Emotionally Disturbed Children | 1725 Shivers Rd, Columbia, SC 29210-5413 | 2012-12-14 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1700413838 | Alexis Koreema Brown | Social Worker | 3205 Montcrest Rd., Columbia, SC 29210 | 2020-03-26 |
| 1942767843 | Thomas Edwin Cromer | Social Worker | 409 Evelyn Drive, Columbia, SC 29210 | 2019-02-27 |
| 1184193542 | Helen Hoffman Coleman | Pharmacist | 16 Berryhill Road, Ste 109, Columbia, SC 29210 | 2018-11-15 |
| 1356828040 | Latia Kelly Mcdonald | Counselor | 105 Beth Hope Lane, Columbia, SC 29210 | 2018-07-25 |
| 1356892848 | Butterfly Effects LLC | Community/Behavioral Health | 1607 Bentley Court, Columbia, SC 29210 | 2016-10-19 |
| 1114373651 | Lilian Emetu | Nurse Practitioner | 822 Statler Road, Columbia, SC 29210 | 2016-05-13 |
| 1154776433 | Costco Wholesale Corporation | Eyewear Supplier (Equipment, not the service) | 507 Piney Grove Rd, Columbia, SC 29210 | 2016-04-25 |
| 1790167690 | Wanda Al-lahabi | Specialist | 1030 St. Andrews Rd., Suite B-3, Columbia, SC 29210 | 2015-06-26 |
| 1285040279 | Debra R. Smart | Counselor | 652 Bush Road, Suite 216, Columbia, SC 29210 | 2014-07-10 |
| 1144665282 | Snf Transportation LLC | Home Health | 810 Dutch Center Blvd, Columbia, SC 29210 | 2013-05-02 |
| Find all providers in zip 29210 | ||||
| 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 |
|---|---|---|---|---|
| 1902403116 | Pieces 2 Peace Wellness Center, LLC | Community/Behavioral Health | 1105 Belleview St Ste 103, Columbia, SC 29201-1839 | 2020-10-01 |
| 1710507090 | Adahsa Counseling LLC | Community/Behavioral Health | 200 Eascott Pl, Columbia, SC 29229-5502 | 2020-04-16 |
| 1740809862 | Brsi Lp | Community/Behavioral Health | 8901 Farrow Rd, Columbia, SC 29203-8930 | 2020-04-09 |
| 1790324986 | Bransand | Community/Behavioral Health | 402 Nautique Cir, Columbia, SC 29229-7334 | 2020-01-05 |
| 1518513795 | Carolina Family Wellness Clinic, LLC | Community/Behavioral Health | 9153 Two Notch Rd Ste 6, Columbia, SC 29223-5852 | 2019-08-14 |
| 1073174033 | David Hill Consultants, LLC | Community/Behavioral Health | 1818 Pulaski St, Columbia, SC 29201-2381 | 2019-06-21 |
| 1760943005 | Goodecounsel, LLC. | Community/Behavioral Health | 235 Village Walk, Columbia, SC 29209-2166 | 2019-03-28 |
| 1932672961 | Sunshine Counseling Lc | Community/Behavioral Health | 302 Hampton Forest Dr, Columbia, SC 29209-2572 | 2019-01-02 |
| 1285125757 | Carolina Counseling Consultants | Community/Behavioral Health | 7356 Garners Ferry Rd Ste 112, Columbia, SC 29209-2146 | 2018-05-21 |
| 1114414125 | Teal Fire Counseling & Consulting, LLC | Community/Behavioral Health | 10632 Little Patuxent Pkwy Ste 343, Columbia, MD 21044-6239 | 2018-04-16 |
| Find all providers in COLUMBIA | ||||
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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.