PROVISIONS COUNSELING SERVICES LLC (NPI# 1811371842) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1811371842 |
| Entity Type | Organization |
| Organization Name | PROVISIONS COUNSELING SERVICES LLC |
| Practice Address |
6 Executive Ct Lake Wylie SC 29710-9338 |
| Mailing Address |
5115 Mintvale Dr Charlotte NC 28269-1689 |
| Practice Telephone | 7049065558 |
| Mailing Telephone | 7049065558 |
| Enumeration Date | 2015-07-20 |
| Last Update Date | 2015-07-20 |
| Authorized Official Name | SHIRICKA LASHAYE FAIR (EXECUTIVE DIRECTOR) |
| Authorized Official Telephone | 7049065558 |
| Authorized Official Credential | LMFT |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 251S00000X | Community/Behavioral Health | 1484 | NC | Agencies |
| Y | 251S00000X | Community/Behavioral Health | 4611 | SC | Agencies |
| Street Address |
6 EXECUTIVE CT |
| City | LAKE WYLIE |
| State | SC |
| Zip Code | 29710-9338 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1740419894 | Prestige Home Health | Home Health | 6 Executive Ct, Lake Wylie, SC 29710-9338 | 2009-07-10 |
| 1285863324 | Prestige Diabetic Supplies | Durable Medical Equipment & Medical Supplies | 6 Executive Ct, Lake Wylie, SC 29710-9338 | 2009-07-10 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1346728243 | Jessica Pampalone | Pharmacist | 175 Sc-274, Lake Wylie, SC 29710 | 2018-08-02 |
| 1932628344 | Andrew Thomas Sullivan | Student in an Organized Health Care Education/Training Program | 106 Mccall Street, Clover, SC 29710 | 2017-09-18 |
| 1619423449 | Dental Professionals of South Carolina, P.C. | Dentist | 209 Latitude Lane, Clover, SC 29710 | 2016-08-31 |
| 1932538816 | Tara Mehta | Psychologist | 48 Fairway Rdg, Clover, SC 29710 | 2013-11-01 |
| 1710238795 | Hong N Mitchell | Pharmacist | 158 Hwy. 274, Lake Wylie, SC 29710 | 2012-10-01 |
| 1790948602 | Barbara Ellen Anslow-myers | Speech-Language Pathologist | 530 Little Cove Lane, Lake Wylie, SC 29710 | 2008-07-10 |
| 1720200884 | Lake Wylie | Assisted Living Facility | 4877 Charlotte Highway, Lake Wylie, SC 29710 | 2007-05-02 |
| 1790804581 | Phillip Russell Sanford | Pharmacist | 3272 Wicklow Ln, Clover, SC 29710 | 2007-03-29 |
| 1124158472 | Thomas N Stall Sr. | Dentist | 1100 Village Harbor Dr., Lake Wylie, SC 29710 | 2007-03-06 |
| 1043369457 | John Frank Ruocco | Dentist | 140 Highway 274, Clover, SC 29710 | 2007-01-09 |
| Find all providers in zip 29710 | ||||
| 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 |
| 1215541669 | Myndspace Mental Health Education & Consulting, LLC | Community/Behavioral Health | 111 Bantry Cir, Charleston, SC 29414-8089 | 2020-09-03 |
| 1861005431 | Legacy Counseling and Consulting of South Carolina | Community/Behavioral Health | 62 Bridgeway Dr, Laurens, SC 29360-7452 | 2020-08-24 |
| 1093325953 | B & H Consultants LLC | Community/Behavioral Health | 1965 Baggette Rd, Manning, SC 29102-7643 | 2020-08-05 |
| 1649896770 | New Wave Counseling Services, LLC | Community/Behavioral Health | 175 Guiomar Rd, Cordova, SC 29039-9344 | 2020-06-24 |
| 1871116517 | Transcendence Treatment Center, LLC | Community/Behavioral Health | 3900 Leeds Ave Ste 101, North Charleston, SC 29405-7461 | 2020-05-28 |
| 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 |
| 1881224954 | Kimberly Lynette Merritts | Community/Behavioral Health | 1550 N Williston Rd, Florence, SC 29506-8744 | 2020-01-17 |
| 1790324986 | Bransand | Community/Behavioral Health | 402 Nautique Cir, Columbia, SC 29229-7334 | 2020-01-05 |
| Find all providers with the same taxonomy | ||||
| City | LAKE WYLIE |
| Zip Code | 29710 |
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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.