| Advance Behavioral Medicine. Llc | |
|
1626 Cranium Dr Ste 101 Rock Hill SC 29732-3552 | |
| (803) 327-4357 | |
| (803) 324-4357 |
| Full Name | Advance Behavioral Medicine. Llc |
|---|---|
| Speciality | Clinic/Center |
| Location | 1626 Cranium Dr Ste 101, Rock Hill, South Carolina |
| Authorized Official Name and Position | Delfin Valite (PSYCHIATRIST) |
| Authorized Official Contact | 8033274357 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Advance Behavioral Medicine. Llc Po Box 36624 Rock Hill SC 29732-0510 Ph: (803) 327-4357 | Advance Behavioral Medicine. Llc 1626 Cranium Dr Ste 101 Rock Hill SC 29732-3552 Ph: (803) 327-4357 |
| NPI Number | 1770542540 |
|---|---|
| Provider Enumeration Date | 03/21/2006 |
| Last Update Date | 11/01/2024 |
| Certification Date | 11/01/2024 |
| Medicare PECOS PAC ID | 1951362102 |
|---|---|
| Medicare Enrollment ID | O20041021000649 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1770542540 | NPI | - | NPPES |
| 229461 | Medicaid | SC | |
| GP3453 | Medicaid | SC |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | 22946 (South Carolina) | Primary |
| Provider Name | Carla A Gibson-detering |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1164483343 PECOS PAC ID: 2163411661 Enrollment ID: I20041112001021 |
| Provider Name | Delfin Valite |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1295794428 PECOS PAC ID: 0749241990 Enrollment ID: I20070604000104 |
| Provider Name | Ruth C Walkup |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1134285448 PECOS PAC ID: 1850469875 Enrollment ID: I20081003000603 |
| Provider Name | Leah Anderson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1356715668 PECOS PAC ID: 7113291964 Enrollment ID: I20170919000010 |
| Provider Name | Chakun Mcdaniel |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1316416555 PECOS PAC ID: 7810237765 Enrollment ID: I20190313000483 |
| Provider Name | Lisa Maria Norton |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1114290236 PECOS PAC ID: 7911377155 Enrollment ID: I20230103002990 |
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