Healthcare Provider Details

I. General information

NPI: 1255334009
Provider Name (Legal Business Name): KEYSTONE BEHAVIORAL HEALTH
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/24/2005
Last Update Date: 06/23/2026
Certification Date: 06/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

199 S HERLONG AVE
ROCK HILL SC
29732-1186
US

IV. Provider business mailing address

PO BOX 4437
ROCK HILL SC
29732-6437
US

V. Phone/Fax

Practice location:
  • Phone: 803-324-1800
  • Fax: 803-328-3831
Mailing address:
  • Phone: 803-324-1800
  • Fax: 803-328-3831

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code261QR0405X
TaxonomySubstance Use Disorder Rehabilitation Clinic/Center
License NumberDHEC OTP-44
License Number StateSC
# 4
Primary TaxonomyN
Taxonomy Code291U00000X
TaxonomyClinical Medical Laboratory
License Number
License Number State
# 5
Primary TaxonomyN
Taxonomy Code324500000X
TaxonomySubstance Abuse Rehabilitation Facility
License NumberDHEC ITP-025
License Number StateSC

VIII. Authorized Official

Name: DR. KERRI MCGUIRE
Title or Position: EXECUTIVE DIRECTOR
Credential: PHD, LPC, NCC
Phone: 803-323-6851