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General NPI Number Information
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NPI Number | 1609825264
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Entity Type | Organization
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Legal Business Name | SOUTH CAROLINA DEPT OF MENTAL HEALTH ACCOUNTING OFFICE
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Dates
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Enumeration Date | 05/09/2006
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Last Update Date | 09/12/2024
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Provider Practice Location Address
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Address Line | 220 FAISON DR
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City | COLUMBIA
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State | SC
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Zip | 29203-3210
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Country | US
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Telephone | 803-898-8405
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Fax | 803-898-8526
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Provider Business Mailing Address
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Address Line | PO BOX 485
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City | COLUMBIA
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State | SC
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Zip | 29202-0485
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Country | US
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Telephone | 803-898-8405
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Fax | 803-898-8526
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Authorized Official
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Title or Position | ASSISTANT DEPUTY DIRECTOR
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Name | TRACY L TURNER
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Credential |
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Telephone | 803-898-4594
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103T00000X
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Taxonomy Name | Psychologist
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 364SP0808X
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Taxonomy Name | Psychiatric/Mental Health Clinical Nurse Specialist
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License Number |
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License Number State |
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Taxonomy #5
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Taxonomy Code | 283Q00000X
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Taxonomy Name | Psychiatric Hospital
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License Number |
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License Number State |
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