| Bluffton Okatie Counseling Center, Llc | |
|
61 Riverwalk Blvd Ste H Ridgeland SC 29936-3252 | |
| (843) 636-5017 | |
| (843) 206-0256 |
| Full Name | Bluffton Okatie Counseling Center, Llc |
|---|---|
| Speciality | Social Worker |
| Location | 61 Riverwalk Blvd Ste H, Ridgeland, South Carolina |
| Authorized Official Name and Position | Leigh Diotalevi (ADMINISTRATOR) |
| Authorized Official Contact | 8436365017 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Bluffton Okatie Counseling Center, Llc 61 Riverwalk Blvd Ste H Ridgeland SC 29936-3252 Ph: (843) 636-5017 | Bluffton Okatie Counseling Center, Llc 61 Riverwalk Blvd Ste H Ridgeland SC 29936-3252 Ph: (843) 636-5017 |
| NPI Number | 1225544562 |
|---|---|
| Provider Enumeration Date | 12/22/2017 |
| Last Update Date | 10/24/2022 |
| Certification Date | 10/24/2022 |
| Medicare PECOS PAC ID | 4880956408 |
|---|---|
| Medicare Enrollment ID | O20180320001031 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1225544562 | NPI | - | NPPES |
| PG1073 | Medicaid | SC |
| Provider Name | Leigh Diotalevi |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1215394838 PECOS PAC ID: 7416219035 Enrollment ID: I20180508002077 |
| Provider Name | Mary Michael Hanbury |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1316581960 PECOS PAC ID: 5698193472 Enrollment ID: I20200910001173 |
| Provider Name | Hevylla K Landing |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1922582923 PECOS PAC ID: 8628487642 Enrollment ID: I20210504001237 |
| Provider Name | Jena Bus |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1952019150 PECOS PAC ID: 7416327424 Enrollment ID: I20230109002924 |
| Provider Name | Kendra Malia Evans |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1467843821 PECOS PAC ID: 5698147734 Enrollment ID: I20230217001888 |
| Provider Name | Kalen H Kelly |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1225743149 PECOS PAC ID: 4385183664 Enrollment ID: I20240830000470 |
| Provider Name | Mary Hoffman |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1962177758 PECOS PAC ID: 9335671635 Enrollment ID: I20241011000180 |
| Provider Name | Karen Bulson |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1780997916 PECOS PAC ID: 5597299255 Enrollment ID: I20241118001242 |
| Provider Name | Christina Bullard |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1518323872 PECOS PAC ID: 7618377110 Enrollment ID: I20250121001803 |
| Provider Name | Jada M Reilley |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1083397293 PECOS PAC ID: 5092244707 Enrollment ID: I20250124002758 |
| Provider Name | Tiffany J Irizarry |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1689294597 PECOS PAC ID: 5294264446 Enrollment ID: I20250203000192 |
| Provider Name | Sheila Dill |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1124427372 PECOS PAC ID: 8325569536 Enrollment ID: I20250304003242 |
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