MEDICARE: NOVUMHEALTH SC, LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy
1	101YM0800X	Mental Health Counselor
2	103TA0400X	Addiction (Substance Use Disorder) Psychologist
3	103TC0700X	Clinical Psychologist
4	1041C0700X	Clinical Social Worker
5	101YA0400X	Addiction (Substance Use Disorder) Counselor
6	2084P0804X	Child & Adolescent Psychiatry Physician
7	2084P0800X	Psychiatry Physician

General Provider Information

NPI Number	:	1164357232
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	NOVUMHEALTH SC, LLC

Provider Business Mailing Address
First Line	:	10900 WAYZATA BLVD STE 710
Second Line	:
City	:	MINNETONKA
State	:	MN
Zip	:	55305-5603
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	2 OFFICE PARK CT STE 103
Second Line	:
City	:	COLUMBIA
State	:	SC
Zip	:	29223-5948
Country	:	US
Telephone Number	:	919-619-1368
Fax Number	:

Authorized Official
Title or Position	:	CHIEF MEDICAL OFFICER
Name	:	MEHUL MANKAD
Credential	:	MD
Telephone Number	:	919-619-1368

Provider Enumeration Date	:	06/17/2026
Last Update Date	:	06/17/2026

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