| Sumter Behavioral Health Llc | |
|
3180 Broad St Sumter SC 29150-1811 | |
| (410) 773-1176 | |
| Not Available |
| Full Name | Sumter Behavioral Health Llc |
|---|---|
| Speciality | Psychiatry & Neurology |
| Location | 3180 Broad St, Sumter, South Carolina |
| Authorized Official Name and Position | Russell Flathmann (MANAGER) |
| Authorized Official Contact | 4107731176 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Sumter Behavioral Health Llc 3180 Broad St Sumter SC 29150-1811 Ph: (410) 773-1176 | Sumter Behavioral Health Llc 3180 Broad St Sumter SC 29150-1811 Ph: (410) 773-1176 |
| NPI Number | 1699529776 |
|---|---|
| Provider Enumeration Date | 04/15/2024 |
| Last Update Date | 04/15/2024 |
| Certification Date | 04/15/2024 |
| Medicare PECOS PAC ID | 2264809326 |
|---|---|
| Medicare Enrollment ID | O20240618003755 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1699529776 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084P0800X | Psychiatry & Neurology - Psychiatry | (* (Not Available)) | Primary |
| Provider Name | Ashleigh Love Quick Ledford |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1801233523 PECOS PAC ID: 6507114113 Enrollment ID: I20180730001628 |
| Provider Name | Robert Mccreery Flowers |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1386138964 PECOS PAC ID: 5294071189 Enrollment ID: I20210607001020 |
| Provider Name | Shana Monique Davis |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1326356635 PECOS PAC ID: 0547413387 Enrollment ID: I20220811003903 |
| Provider Name | Aubrey Rickard Holladay |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1629793872 PECOS PAC ID: 3870962731 Enrollment ID: I20221215001716 |
| Provider Name | Jelinda S Cherry Stokes |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1811452360 PECOS PAC ID: 9133590417 Enrollment ID: I20230124002945 |
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