| South Carolina Dept Of Mental Health Accounting Office | |
|
124 Mallard St Greenville SC 29601-4046 | |
| (864) 241-1040 | |
| (864) 241-1215 |
| Full Name | South Carolina Dept Of Mental Health Accounting Office |
|---|---|
| Speciality | Clinic/Center |
| Location | 124 Mallard St, Greenville, South Carolina |
| Authorized Official Name and Position | Jennifer Crowe (BILLING) |
| Authorized Official Contact | 8642411040 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| South Carolina Dept Of Mental Health Accounting Office 124 Mallard St Greenville SC 29601-4046 Ph: (864) 241-1040 | South Carolina Dept Of Mental Health Accounting Office 124 Mallard St Greenville SC 29601-4046 Ph: (864) 241-1040 |
| NPI Number | 1619995370 |
|---|---|
| Provider Enumeration Date | 07/18/2006 |
| Last Update Date | 12/18/2023 |
| Certification Date | 12/18/2023 |
| Medicare PECOS PAC ID | 9032021175 |
|---|---|
| Medicare Enrollment ID | O20040624000139 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1619995370 | NPI | - | NPPES |
| 301100 | Medicaid | SC |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | (* (Not Available)) | Primary |
| Provider Name | Deborah Dobson Moore |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1437131257 PECOS PAC ID: 6901898998 Enrollment ID: I20040331000638 |
| Provider Name | Alfred C Edwards |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1952315780 PECOS PAC ID: 9133104987 Enrollment ID: I20050216000679 |
| Provider Name | Lisa Lewandowski Wischhusen |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1982645016 PECOS PAC ID: 2860422961 Enrollment ID: I20050818000312 |
| Provider Name | Ervin D Prewette |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1851303200 PECOS PAC ID: 9830197110 Enrollment ID: I20061121000142 |
| Provider Name | Lynn P Wright |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1346332137 PECOS PAC ID: 5092715763 Enrollment ID: I20070102000354 |
| Provider Name | Elena Dlugach |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1740393206 PECOS PAC ID: 8628138955 Enrollment ID: I20081117000651 |
| Provider Name | Geera N Desai |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1184684961 PECOS PAC ID: 6709098114 Enrollment ID: I20101119001067 |
| Provider Name | Evan L Vogel |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1235143066 PECOS PAC ID: 0547435000 Enrollment ID: I20111212000299 |
| Provider Name | Eve Ariel Fields |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1417052234 PECOS PAC ID: 9739281486 Enrollment ID: I20160614002123 |
| Provider Name | Geetika Dembla |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1164626875 PECOS PAC ID: 1456548890 Enrollment ID: I20180515000509 |
| Provider Name | Michael Anthony Sierra |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1720491640 PECOS PAC ID: 8022307842 Enrollment ID: I20190909003846 |
| Provider Name | Erin Marie Mcgeachie |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1801452149 PECOS PAC ID: 2860814233 Enrollment ID: I20200612002034 |
| Provider Name | Lauren H Levy |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1104276641 PECOS PAC ID: 4486949815 Enrollment ID: I20201013003247 |
| Provider Name | Thomas Carl Mcminn |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1962714477 PECOS PAC ID: 8921442278 Enrollment ID: I20240215000158 |
| Provider Name | Jessica Ilo Clark |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1902385875 PECOS PAC ID: 0941649800 Enrollment ID: I20240411004537 |
| Provider Name | Aarti Patel |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1336285618 PECOS PAC ID: 7315386034 Enrollment ID: I20240415001881 |
| Provider Name | Rebecca Danielle Stephens |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1194734608 PECOS PAC ID: 3375982929 Enrollment ID: I20240416003068 |
| Provider Name | Linda Lee Graddy |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1033220181 PECOS PAC ID: 0840639209 Enrollment ID: I20240417003853 |
| Provider Name | Kristi Brown Harrington |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1528398583 PECOS PAC ID: 8426499187 Enrollment ID: I20240513000292 |
| Provider Name | Amanda Blanton |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1821855107 PECOS PAC ID: 9436689403 Enrollment ID: I20250205002708 |
| Provider Name | Thomas Ray Martin |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1598131187 PECOS PAC ID: 3274063029 Enrollment ID: I20250207002683 |
| Provider Name | Shelia Renae Harris |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1356923106 PECOS PAC ID: 9830361195 Enrollment ID: I20250430000520 |
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Clarity, Inc. Mental Health Clinic Medicare: Medicare Enrolled Practice Location: 29 N Academy St, Greenville, SC 29601 Phone: 864-331-1400 Fax: 864-331-1416 | |
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A Child's Bright Start Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 22 Pleasant Ridge Ave, Greenville, SC 29605 Phone: 214-601-6208 | |
South Carolina Dept Of Mental Health Accounting Office Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 124 Mallard St, Greenville, SC 29601 Phone: 864-241-1040 Fax: 864-241-1215 |