| Mirci | |
|
3809 Rosewood Dr Columbia SC 29205-3533 | |
| (803) 786-1844 | |
| (803) 939-2646 |
| Full Name | Mirci |
|---|---|
| Speciality | Community/Behavioral Health |
| Location | 3809 Rosewood Dr, Columbia, South Carolina |
| Authorized Official Name and Position | Julie Ann Avin (PRESIDENT & EXECUTIVE DIRECTOR) |
| Authorized Official Contact | 8037861844 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Mirci 1408 Gregg St Columbia SC 29201 Ph: (803) 786-1844 | Mirci 3809 Rosewood Dr Columbia SC 29205-3533 Ph: (803) 786-1844 |
| NPI Number | 1194047563 |
|---|---|
| Provider Enumeration Date | 02/25/2010 |
| Last Update Date | 09/02/2020 |
| Certification Date | 09/02/2020 |
| Medicare PECOS PAC ID | 1658564562 |
|---|---|
| Medicare Enrollment ID | O20101025000289 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1194047563 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
| Provider Name | Nancy B Hyman |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1043415185 PECOS PAC ID: 2264447093 Enrollment ID: I20060215000025 |
| Provider Name | John C Steele |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1942350616 PECOS PAC ID: 7719085869 Enrollment ID: I20070613000340 |
| Provider Name | Margaret S Johnson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1750535530 PECOS PAC ID: 3375691553 Enrollment ID: I20090427000528 |
| Provider Name | John Buckland |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1871623413 PECOS PAC ID: 6608909015 Enrollment ID: I20100805000867 |
| Provider Name | Kristin L Remke Clary |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1659571503 PECOS PAC ID: 3173762028 Enrollment ID: I20130625000615 |
| Provider Name | Twanda D Addison |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1699004333 PECOS PAC ID: 6002042579 Enrollment ID: I20131112001345 |
| Provider Name | Bradley N Martin |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1144729153 PECOS PAC ID: 5294096541 Enrollment ID: I20201103002406 |
| Provider Name | Charles Zane Crumpler |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1528618675 PECOS PAC ID: 6204245053 Enrollment ID: I20210506001570 |
| Provider Name | Leah R Hunter |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1619515632 PECOS PAC ID: 4284038274 Enrollment ID: I20210812004010 |
| Provider Name | James Van Jefferson |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1932716172 PECOS PAC ID: 0446621783 Enrollment ID: I20230124000669 |
| Provider Name | Caroline W Kearns |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1750019923 PECOS PAC ID: 0840649778 Enrollment ID: I20231218001220 |
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