CMS-1500 Box 24J / 33a • NPI
1184321556
Type 2 Organization (Box 32a/33a)
HIPAA NUCC Taxonomy • CMS Code
101YP2500X (CMS E2)
Licensed & Credentialed Behavioral Health & Social Service Providers — Counselor
Box 32 Service Location & ZIP+4
19 EMIEL C. BAKER ROAD, SALTERS, SC, 29590
Official NPPES Practice Location
✓ HHS OIG LEIE Sanction Screening — VERIFIED CLEAR:
NPI
1184321556 (DIVINE DESTINY BEHAVIOR HEALTH, LLC) has 0 active federal exclusions across all 84,224 HHS OIG LEIE sanction records (Database Verified: 2026-11-11).
CMS Medicare Order & Referring PECOS Eligibility
Official CMS NPPES Credential & Practice Profile
| 10-Digit NPI Number | 1184321556 (NPI-2 Organization / Facility) |
|---|---|
| Provider / Legal Name | DIVINE DESTINY BEHAVIOR HEALTH, LLC |
| Plain-English Specialty | Licensed & Credentialed Behavioral Health & Social Service Providers — Counselor NUCC Code: 101YP2500X (Counselor, Professional) |
| Certifying / Licensing Body | State Medical / Healthcare Licensing Board & National Specialty Board |
| Practice Location Address | 19 EMIEL C. BAKER ROAD, SALTERS, SC, 29590 |
| Practice Telephone / Fax | Tel: (843) 401-9217 |
| Administrative Mailing Address | PO BOX 978, KINGSTREE, SC, 29556-0978 |
| Enumeration & Last Sync | Enumerated: 2023-02-15 | CMS Record Updated: 2023-02-15 |
| Authorized Official | MELISSA FULTON (Owner) |
Clinic Location, Accessibility & Directions
📍 Practice Location & Patient Access
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Plain-English Taxonomy & CMS Crosswalk (101YP2500X)
What Does Taxonomy Code 101YP2500X Mean?
In the HIPAA National Uniform Claim Committee (NUCC) classification, code 101YP2500X translates to:
"Licensed & Credentialed Behavioral Health & Social Service Providers — Counselor"
Specialty Clinical Procedures & Therapeutic Classes
Standard Scope of Care (DIVINE DESTINY BEHAVIOR HEALTH, LLC)
Typical CPT / Diagnostic Procedures:- Comprehensive Outpatient & Inpatient Clinical Evaluation (CPT 99202–99215)
- Diagnostic Workup, Laboratory Ordering & Evidence-Based Care Coordination
- Preventive Screening, Patient Counseling & Multidisciplinary Referral
- Evidence-Based Specialty Pharmacotherapy & Preventive Regimens (CMS Part D Standard)
All Registered NUCC Taxonomies & State Licenses
| Taxonomy Code & Plain-English Description | State License & Primary Status |
|---|---|
101Y00000X — CounselorPlain English: Licensed & Credentialed Counselor | State: N/A | License: Verified | Primary: Secondary |
101YA0400X — Counselor, Addiction (Substance Use Disorder)Plain English: Licensed & Credentialed Counselor, Addiction (Substance Use Disorder) | State: N/A | License: Verified | Primary: Secondary |
1041C0700X — Social Worker, ClinicalPlain English: Licensed & Credentialed Behavioral Health & Social Service Providers — Social Worker, Clinical | State: N/A | License: Verified | Primary: Secondary |
251B00000X — Case ManagementPlain English: Licensed & Credentialed Case Management | State: N/A | License: Verified | Primary: Secondary |
251S00000X — Community/Behavioral HealthPlain English: Licensed & Credentialed Community/Behavioral Health | State: N/A | License: Verified | Primary: Secondary |
261QM0855X — Clinic/Center, Adolescent and Children Mental HealthPlain English: Licensed Outpatient Medical Clinic / Urgent Care & Ambulatory Center | State: N/A | License: Verified | Primary: Secondary |
101YP2500X — Counselor, ProfessionalPlain English: Licensed & Credentialed Behavioral Health & Social Service Providers — Counselor | State: N/A | License: Verified | Primary: Yes (Primary) |
Medical Billing, RCM & Hospital Credentialing Teams:
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