Healthcare Provider Details

I. General information

NPI: 1689677700
Provider Name (Legal Business Name): DANIEL PISTONE, MD PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/23/2005
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

200 OAKLAND AVE STE D
ROCK HILL SC
29730-4022
US

IV. Provider business mailing address

PO BOX 11647
ROCK HILL SC
29731-1647
US

V. Phone/Fax

Practice location:
  • Phone: 803-324-7779
  • Fax: 803-981-7792
Mailing address:
  • Phone: 803-324-7792
  • Fax: 803-981-7792

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number1260
License Number StateSC
# 2
Primary TaxonomyN
Taxonomy Code104100000X
TaxonomySocial Worker
License Number5558
License Number StateSC
# 3
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number2600
License Number StateSC

VIII. Authorized Official

Name: MRS. CYNTHIA D MCJUNKIN
Title or Position: OFFICE MANAGER
Credential:
Phone: 803-324-7792