Healthcare Provider Details

I. General information

NPI: 1578772976
Provider Name (Legal Business Name): FAMILY MEDICINE & PSYCHIATRY OF THE CAROLINAS AT ROCK HILL PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/22/2007
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1420 EBENEZER RD SUITE 105
ROCK HILL SC
29732-2743
US

IV. Provider business mailing address

1420 EBENEZER RD SUITE 105
ROCK HILL SC
29732-2743
US

V. Phone/Fax

Practice location:
  • Phone: 803-324-7792
  • 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 Number2837
License Number StateSC
# 2
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number6904
License Number StateSC
# 3
Primary TaxonomyN
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number2600
License Number StateSC
# 4
Primary TaxonomyY
Taxonomy Code2084P0015X
TaxonomyPsychosomatic Medicine Physician
License Number26858
License Number StateSC

VIII. Authorized Official

Name: MR. DANIEL N PISTONE
Title or Position: OWNER
Credential: MD
Phone: 803-324-7792