It's Your Move | |
425 Summit Terrace Ct Ste 7b Columbia SC 29229-7055 | |
(877) 471-9865 | |
(803) 335-5343 |
Full Name | It's Your Move |
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Speciality | Clinic/Center |
Location | 425 Summit Terrace Ct Ste 7b, Columbia, South Carolina |
Authorized Official Name and Position | Deeneka Lachelle Beach-phelps (CEO) |
Authorized Official Contact | 8774719865 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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It's Your Move 425 Summit Terrace Ct Ste 7b Columbia SC 29229-7055 Ph: (877) 471-9865 | It's Your Move 425 Summit Terrace Ct Ste 7b Columbia SC 29229-7055 Ph: (877) 471-9865 |
NPI Number | 1568114999 |
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Provider Enumeration Date | 01/26/2022 |
Last Update Date | 01/26/2022 |
Medicare PECOS PAC ID | 4880056837 |
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Medicare Enrollment ID | O20240318001623 |
Identifier | Type | State | Issuer |
---|---|---|---|
1568114999 | NPI | - | NPPES |
GP8718 | Medicaid | SC |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
261QP2300X | Clinic/center - Primary Care | (* (Not Available)) | Primary |
Provider Name | Stanton J Smith |
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Provider Type | Practitioner - Psychiatry |
Provider Identifiers | NPI Number: 1679546451 PECOS PAC ID: 3577570993 Enrollment ID: I20060418000744 |
Provider Name | Lakesha Shingler Howell |
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Provider Type | Practitioner - Clinical Social Worker |
Provider Identifiers | NPI Number: 1609117100 PECOS PAC ID: 3971880675 Enrollment ID: I20190805000491 |
Provider Name | Kenneth Martin |
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Provider Type | Practitioner - Mental Health Counselor |
Provider Identifiers | NPI Number: 1093899007 PECOS PAC ID: 4183076789 Enrollment ID: I20240318001765 |
Provider Name | Shanta Ogwe |
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Provider Type | Practitioner - Marriage And Family Therapist |
Provider Identifiers | NPI Number: 1598236093 PECOS PAC ID: 5698206738 Enrollment ID: I20241001001036 |
Northlake Family Medical Practice Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 3000 Ne Medical Park, Ste 101, Columbia, SC 29223 Phone: 803-419-5131 Fax: 803-419-5130 | |
Lagniappe Medical Clinics, Llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 74 Polo Rd, Columbia, SC 29223 Phone: 803-419-7780 Fax: 803-419-7781 | |