List of Approved Providers for SCDDSN Waiver Psych Services
List of Approved Providers for SCDDSN Waiver Psych Services
List of Approved Providers for SCDDSN Waiver Psych Services
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<strong>List</strong> <strong>of</strong> <strong>Approved</strong> <strong>Providers</strong> <strong>for</strong> <strong>SCDDSN</strong> <strong>Waiver</strong> <strong>Psych</strong> <strong>Services</strong><br />
9/3/2013<br />
Name Provider Medicaid # Address/Phone #<br />
Status<br />
<strong>Approved</strong> Areas <strong>of</strong> Competence/Expertise<br />
Page 1<br />
Kimberly A. Adkins<br />
<strong>Approved</strong><br />
Counseling <strong>Services</strong><br />
Risk Assessments/Sexual Aggression<br />
WP9951<br />
Counties Served:<br />
Statewide<br />
324 Pelling Drive<br />
York SC 29745<br />
(803) 207-1857<br />
Amy Bennett-Beasley<br />
<strong>Approved</strong>/Not Accepting New Referrals<br />
Behavior Support<br />
WP9903<br />
Counties Served:<br />
Statewide<br />
213 Rindle Drive<br />
Lexington SC 29072<br />
(803) 808-9882<br />
Sonya Boler<br />
<strong>Approved</strong><br />
Counseling <strong>Services</strong><br />
WP8948<br />
Counties Served:<br />
Chester<br />
Lancaster<br />
Rock Hill<br />
York<br />
4017 Hathaway Hills Drive<br />
Charlotte NC 28214<br />
(704) 713-7808<br />
Anthony Bromell<br />
<strong>Approved</strong><br />
Behavior Support<br />
Winfield Brown<br />
<strong>Approved</strong><br />
Counseling <strong>Services</strong><br />
WP8926<br />
Counties Served:<br />
Berkeley<br />
Calhoun<br />
Clarendon<br />
Colleton<br />
Darlington<br />
Dorchester<br />
Dillon<br />
Florence<br />
Georgetown<br />
Horry<br />
Kershaw<br />
Lee<br />
Lexington<br />
Marion<br />
Orangeburg<br />
Richland<br />
Sumter<br />
Williamsburg<br />
WP9991<br />
Counties Served:<br />
Florence<br />
2957 Mary Hines Lane<br />
Georgetown SC 29440<br />
(843) 520-2917<br />
410 Poplar Street<br />
Florence SC 29501 5126<br />
(843) 661-6182<br />
Lysander (Sandy) Byerly<br />
<strong>Approved</strong><br />
Behavior Support<br />
WP8942<br />
Counties Served:<br />
Orangeburg<br />
9 Byerly Lane<br />
Gilbert SC 29054 8566<br />
(803) 687-8784<br />
Note: Some providers may be approved in several areas and serve different counties.
Name Provider Medicaid # Address/Phone #<br />
Status<br />
<strong>Approved</strong> Areas <strong>of</strong> Competence/Expertise<br />
Page 2<br />
John M. Carithers<br />
<strong>Approved</strong><br />
Behavior Support<br />
WP8955<br />
Counties Served:<br />
Babcock Center<br />
Babcock Center<br />
PO Box 4389<br />
West Columbia SC 29171<br />
(803) 799-1970 Extension 161<br />
J. Trent Cason<br />
<strong>Approved</strong><br />
Behavior Support<br />
Laura Chezan<br />
<strong>Approved</strong>/Not Accepting Referrals<br />
Behavior Support<br />
WP9963<br />
Counties Served:<br />
McCormick<br />
Greenwood<br />
Saluda<br />
Edgefield<br />
Lexington<br />
Richland<br />
Abbeville<br />
WP8924<br />
Counties Served:<br />
Lexington<br />
Richland<br />
901 Chestnut Ridge Road<br />
McCormick SC 29835<br />
(864) 852-0122<br />
2505 Blossom Street, Apt. D<br />
Columbia SC 29205<br />
(843) 601-3204<br />
Jay Cole<br />
<strong>Approved</strong><br />
Behavior Support<br />
WP9912<br />
Counties Served:<br />
Berkeley<br />
Georgetown<br />
Horry<br />
Marion-Dillon<br />
Applied Behavioral <strong>Services</strong>, Inc.<br />
53 Commons Ct<br />
Pawleys Island SC 29585<br />
(843) 457-2431<br />
Dr. Phillip Cornelius<br />
<strong>Approved</strong><br />
Behavior Support<br />
Kathryn Fox Craw<strong>for</strong>d<br />
<strong>Approved</strong><br />
Counseling <strong>Services</strong><br />
WP8963<br />
Counties Served:<br />
Newberry<br />
Edgefield<br />
Greenwood<br />
Spartanburg<br />
Saluda<br />
Laurens<br />
Union<br />
Kershaw<br />
Fairfield<br />
Anderson<br />
Chester-Lancaster<br />
York<br />
WP9932<br />
Counties Served:<br />
Darlington<br />
Florence<br />
1178 Old Camden Road<br />
Winnsboro SC 29180<br />
(803) 633-5838<br />
814 Mohawk Drive<br />
Florence SC 29501<br />
(843) 661-5071<br />
Note: Some providers may be approved in several areas and serve different counties.
Name Provider Medicaid # Address/Phone #<br />
Status<br />
<strong>Approved</strong> Areas <strong>of</strong> Competence/Expertise<br />
Page 3<br />
Shannon Doughty<br />
<strong>Approved</strong><br />
Behavior Support<br />
WP8971<br />
Counties Served:<br />
Charleston<br />
Dorchester<br />
Berkeley<br />
Carolina Coast Behavioral<br />
<strong>Services</strong>, LLC<br />
Post Office Box 80901<br />
Charleston SC 29416<br />
(843) 259-8853<br />
Jamie Duncan-Chapman<br />
<strong>Approved</strong><br />
Behavior Support<br />
WP8923<br />
Counties Served:<br />
Spartanburg<br />
Charles Lea Center<br />
195 Burdette St.<br />
Spartanburg SC 29307<br />
(864) 472-7464<br />
Carnetha Dunham<br />
<strong>Approved</strong><br />
Behavior Support<br />
Bruce A. Dunlap<br />
<strong>Approved</strong>/Not Accepting New Referrals<br />
Behavior Support<br />
Harvey J. Evans<br />
<strong>Approved</strong><br />
Behavior Support<br />
WP8933<br />
Counties Served:<br />
Berkeley<br />
Calhoun<br />
Clarendon<br />
Darlington<br />
Dillon<br />
Edgefield<br />
Florence<br />
Georgetown<br />
Horry<br />
Kershaw<br />
Lee<br />
Marion<br />
Orangeburg<br />
Richland<br />
Sumter<br />
Williamsburg<br />
WP9901<br />
Counties Served:<br />
Babcock Center<br />
WP8949<br />
Counties Served:<br />
Florence<br />
Darlington<br />
Clarendon<br />
Marion<br />
Dillon<br />
Marlboro<br />
Williamsburg<br />
Lee, Sumter<br />
Anderson<br />
Pickens<br />
Oconee<br />
Total Care Behavioral <strong>Services</strong>,<br />
LLC<br />
1415 N. Buncombe Road<br />
Florence SC 29506<br />
(843) 687-6949<br />
P.O. Box 4389<br />
West Columbia SC 29171<br />
(803) 799-1970 Extension 145<br />
(803) 606-3570<br />
Applied Consulting and Training<br />
<strong>Services</strong><br />
218 Timberlake Drive<br />
Florence SC 29501<br />
(843) 319-2413<br />
(843) 393-9914<br />
Note: Some providers may be approved in several areas and serve different counties.
Name Provider Medicaid # Address/Phone #<br />
Status<br />
<strong>Approved</strong> Areas <strong>of</strong> Competence/Expertise<br />
Page 4<br />
Michelle R. Evans<br />
<strong>Approved</strong><br />
Counseling <strong>Services</strong><br />
Greg Feeback<br />
<strong>Approved</strong><br />
Testing<br />
Gary W. Firmender<br />
<strong>Approved</strong><br />
Behavior Support<br />
WP8936<br />
Counties Served:<br />
Cherokee<br />
Fairfield<br />
Greenville<br />
Laurens<br />
Spartanburg<br />
Union<br />
WP8969<br />
Counties Served:<br />
Bamberg<br />
Barnwell<br />
Calhoun<br />
Fairfield<br />
Kershaw<br />
Lexington<br />
Richland<br />
Newberry<br />
Orangeburg<br />
WP9997<br />
Counties Served:<br />
Statewide<br />
145 North Church Street, Box 10<br />
Spartanburg SC 29306<br />
(864) 266-3393<br />
403 Dover Court<br />
Lexington SC 29072<br />
(803) 309-4763<br />
Developmental & Behavioral<br />
<strong>Services</strong>, Inc.<br />
P.O. Box 308<br />
Isle <strong>of</strong> Palms SC 29451 0308<br />
Debbie Gabriel<br />
<strong>Approved</strong><br />
Behavior Support<br />
WP8982<br />
Counties Served: Horry<br />
Clarendon<br />
Georgetown<br />
(843) 330-8180<br />
849 Wind Whisper Circle<br />
Murrells Inlet SC 29576<br />
(843) 283-2783<br />
Barvette Gaither<br />
<strong>Approved</strong><br />
Counseling <strong>Services</strong><br />
WP8940<br />
Counties Served: York<br />
1379 Pampas Circle<br />
Rock Hill SC 29732<br />
(803) 524-2432<br />
Tomika Gantt<br />
<strong>Approved</strong><br />
Counseling <strong>Services</strong> (Sexual Aggression)<br />
WP8951<br />
Counties Served:<br />
Chester<br />
CHESCO<br />
Lancaster<br />
York<br />
Gantt<br />
<strong>Psych</strong>otherapeutic/Consultation<br />
Svs<br />
1721 Ebenezer Dr. Ste 265<br />
Rock Hill SC 29732<br />
(704) 968-4893<br />
Dr. Han-Leong Goh<br />
<strong>Approved</strong><br />
Behavior Support<br />
WP9908<br />
Counties Served: Dillon<br />
Georgetown<br />
Horry<br />
Marion<br />
P.O. Box 1574<br />
Dillon SC 29536<br />
(352) 478-1223<br />
Note: Some providers may be approved in several areas and serve different counties.
Name Provider Medicaid # Address/Phone #<br />
Status<br />
<strong>Approved</strong> Areas <strong>of</strong> Competence/Expertise<br />
Page 5<br />
Dennis Goodwin<br />
<strong>Approved</strong><br />
Behavior Support<br />
WP8943<br />
Counties Served:<br />
Statewide<br />
Carolina Behavioral <strong>Services</strong><br />
1053 Oakland Drive<br />
Elgin SC 29045<br />
(803) 413-5798<br />
David S. Green<br />
<strong>Approved</strong><br />
Behavior Support<br />
WP8977<br />
Counties Served: Aiken<br />
DSN Board<br />
339 Bainbridge Drive<br />
Aiken SC 29803<br />
(803) 642-1085<br />
Prue M. Hammett<br />
<strong>Approved</strong><br />
Counseling <strong>Services</strong><br />
WP9931<br />
Counties Served:<br />
Berkeley<br />
Charleston<br />
Counseling Center <strong>of</strong> Charleston<br />
1041 Johnnie Dodds Blvd., Suite 5C<br />
Mt. Pleasant SC 29464<br />
(843) 856-8975<br />
Dr. Diane D. Hamrick<br />
<strong>Approved</strong><br />
Counseling <strong>Services</strong><br />
WP9938<br />
Counties Served:<br />
Berkeley<br />
Charleston<br />
Colleton<br />
Dorchester<br />
655 St. Andrews Blvd.<br />
Charleston SC 29407 0655<br />
(843) 571-2040<br />
Dr. Wilton L. Hellams, Jr.<br />
<strong>Approved</strong><br />
Counseling <strong>Services</strong><br />
Charles A. Holden, III<br />
<strong>Approved</strong><br />
Counseling <strong>Services</strong><br />
WP9989<br />
Counties Served:<br />
Calhoun<br />
Chester<br />
Darlington<br />
Fairfield<br />
Greenville<br />
Kershaw<br />
Lancaster<br />
Lee<br />
Lexington<br />
Newberry<br />
Orangeburg<br />
Richland<br />
Spartanburg<br />
Sumter<br />
York<br />
WP9946<br />
Counties Served:<br />
Darlington<br />
Dillon<br />
Florence<br />
Lexington<br />
Marion<br />
Richland<br />
1 Chukker Hill Court<br />
Columbia SC 29223<br />
(803) 699-1822<br />
331 Laurel Lane<br />
Florence SC 29506<br />
(843) 662-8275<br />
(800) 864-0926 Extension 9189<br />
Note: Some providers may be approved in several areas and serve different counties.
Name Provider Medicaid # Address/Phone #<br />
Status<br />
<strong>Approved</strong> Areas <strong>of</strong> Competence/Expertise<br />
Page 6<br />
Dr. Charles W Jackson<br />
<strong>Approved</strong><br />
Testing<br />
PS0436<br />
Counties Served: Horry<br />
Georgetown<br />
Marion<br />
Florence<br />
5335 N. Kings Hwy, PMB 120<br />
Myrtle Beach SC 29577<br />
(843) 503-2000<br />
Kelly Kennedy<br />
<strong>Approved</strong><br />
Testing<br />
Dr. Thomas F. Kirby<br />
<strong>Approved</strong><br />
Testing<br />
Danielle Pritchard Lamb<br />
<strong>Approved</strong><br />
Testing<br />
WP8938<br />
Counties Served:<br />
Cherokee<br />
Spartanburg<br />
York<br />
Greenville<br />
Union<br />
Chester<br />
WP8959<br />
Counties Served:<br />
Abbeville<br />
Anderson<br />
Cherokee<br />
Edgefield<br />
Greenville<br />
Greenwood<br />
Laurens<br />
McCormick<br />
Oconee<br />
Pickens<br />
Saluda<br />
Spartanburg<br />
Union<br />
WP8929<br />
Counties Served:<br />
Greenville<br />
Spartanburg<br />
1120 Ninety-Nine Island Road<br />
Blacksburg SC 29702<br />
(864) 839-4801<br />
(864) 206-2244<br />
109 Fillery Drive<br />
Greenville SC 29615<br />
(864) 288-9445<br />
259 Faye Court<br />
Greer SC 29651<br />
(704) 477-7833<br />
Laura Lapen<br />
<strong>Approved</strong><br />
Behavior Support<br />
WP9917<br />
Counties Served:<br />
Darlington<br />
Florence<br />
Horry<br />
Marlboro<br />
1221 E. Jefferson Street<br />
Dillon SC 29536<br />
(910) 231-1909<br />
Sherese Leonard<br />
<strong>Approved</strong><br />
Testing<br />
WP8956<br />
Counties Served:<br />
Statewide<br />
2220 L Woodbridge Lane<br />
Florence SC 29501<br />
(843) 468-1427<br />
Christian A. Martin<br />
<strong>Approved</strong><br />
Behavior Support<br />
WP8953<br />
Counties Served:<br />
Newberry<br />
Atlas Supports, LLC<br />
82 North Lake Point Drive<br />
Columbia SC 29229<br />
(803) 582-9003<br />
Note: Some providers may be approved in several areas and serve different counties.
Name Provider Medicaid # Address/Phone #<br />
Status<br />
<strong>Approved</strong> Areas <strong>of</strong> Competence/Expertise<br />
Page 7<br />
Rosalyn Kramer Monat-Haller<br />
<strong>Approved</strong>/Will only see at home <strong>of</strong>fice<br />
Counseling <strong>Services</strong><br />
Risk Assessments/Sexual Aggression<br />
WP9960<br />
Counties Served:<br />
Statewide<br />
P.O. Box 2103<br />
Summerville SC 29484 2103<br />
(843) 873-6935<br />
Mark P. Morgan<br />
<strong>Approved</strong><br />
Behavior Support<br />
Lennie Schlager Mullis<br />
<strong>Approved</strong><br />
Behavior Support<br />
Counseling <strong>Services</strong><br />
WP8928<br />
Counties Served:<br />
Calhoun<br />
Fairfield<br />
Lexington<br />
Newberry<br />
Richland<br />
Saluda<br />
WP9974<br />
Counties Served:<br />
Statewide<br />
811 Neighbor Lane<br />
Lexington SC 29072<br />
(602) 369-3408<br />
1002 L<strong>of</strong>ty Pine Drive<br />
Columbia SC 29212<br />
(803) 781-4437<br />
Bryan Naylor<br />
<strong>Approved</strong><br />
Behavior Support<br />
Obatala Ombu<br />
<strong>Approved</strong><br />
Testing<br />
Daniel Oshields<br />
<strong>Approved</strong><br />
Counseling <strong>Services</strong><br />
Allison Petralia<br />
<strong>Approved</strong><br />
Behavior Support<br />
WP8979<br />
Counties Served:<br />
Anderson<br />
Greenville<br />
Spartanburg<br />
Lurens<br />
Pickens<br />
WP9998<br />
Counties Served:<br />
Clarendon<br />
Darlington<br />
Dillon<br />
Florence<br />
Georgetown<br />
Horry<br />
Lee<br />
Marion<br />
Sumter<br />
Williamsburg<br />
WP8947<br />
Counties Served: Union<br />
Chester<br />
Newberry<br />
Spartanburg<br />
Laurens<br />
Cherokee<br />
York<br />
WP8927<br />
Counties Served:<br />
Anderson<br />
Greenville<br />
Laurens<br />
Spartanburg<br />
Behavioral Intervention<br />
Technologies<br />
PMB#181<br />
2435 East North St. STE 1108<br />
Greenville SC 29615<br />
(407) 373-8581<br />
P.O. Box 1141<br />
Kingstree SC 29556<br />
(843) 372-5959<br />
114 Ralph Ridge<br />
Union SC 29379<br />
(864) 427-9422<br />
751 E. Georgia Road, Ste. 100<br />
Woodruff SC 29388<br />
(864) 476-7400<br />
Note: Some providers may be approved in several areas and serve different counties.
Name Provider Medicaid # Address/Phone #<br />
Status<br />
<strong>Approved</strong> Areas <strong>of</strong> Competence/Expertise<br />
Page 8<br />
Carolyn S. Pinckney<br />
<strong>Approved</strong><br />
Behavior Support<br />
Jerome Prezzy<br />
<strong>Approved</strong><br />
Counseling <strong>Services</strong><br />
Ronald J Rambo<br />
<strong>Approved</strong><br />
Behavior Support<br />
Anthony Dale Rauch<br />
<strong>Approved</strong>/Not Accepting Referrals<br />
Behavior Support<br />
WP8976<br />
Counties Served:<br />
Charleston<br />
Dorchester<br />
Berkeley<br />
Hampton<br />
Colleton<br />
WP9902<br />
Counties Served:<br />
Bamberg<br />
Calhoun<br />
Fairfield<br />
Kershaw<br />
Lexington<br />
Orangeburg<br />
Richland<br />
Sumter<br />
WP8930<br />
Counties Served:<br />
Fairfield<br />
Greenwood<br />
Laurens<br />
Lexington<br />
Newberry<br />
Richland<br />
Saluda<br />
WP8973<br />
Counties Served:<br />
Statewide<br />
Guiding Light Pr<strong>of</strong>essional<br />
Behavioral Service, LLC<br />
Post Office Box 41785<br />
North Charleston SC 29423<br />
(843) 552-5218<br />
209 Pinckney Drive<br />
Columbia SC 29209<br />
(803) 467-5822<br />
(803) 799-1136<br />
Behavioral Support Systems, LLC<br />
139 Three Oaks Court<br />
Prosperity SC 29127<br />
(803) 271-2533<br />
671 Twin Pine Drive<br />
Chapin SC 29036<br />
(803) 348-0146<br />
Kimberly S. Roddy<br />
<strong>Approved</strong><br />
Behavior Support<br />
WP9905<br />
Counties Served:<br />
Statewide<br />
Supportive Consultation <strong>Services</strong>,<br />
LLC<br />
106 Woodland Circle<br />
Cheraw SC 29520<br />
(843) 537-0303<br />
Donald Shockley<br />
<strong>Approved</strong><br />
Behavior Support<br />
WP8970<br />
Counties Served:<br />
Pickens<br />
Pickens DSN Board<br />
Post Office Box 1308<br />
Easley SC 29641<br />
(864) 859-5416<br />
Bertha Prezzy Snow<br />
<strong>Approved</strong><br />
Counseling <strong>Services</strong><br />
WP8978<br />
Counties Served:<br />
Calhoun<br />
Fairfield<br />
Lee<br />
Orangeburg<br />
Richland<br />
114 South Down Drive<br />
Columbia SC 29209<br />
(803) 647-9164<br />
Note: Some providers may be approved in several areas and serve different counties.
Name Provider Medicaid # Address/Phone #<br />
Status<br />
<strong>Approved</strong> Areas <strong>of</strong> Competence/Expertise<br />
Page 9<br />
Gretchen Sparacino<br />
<strong>Approved</strong><br />
Counseling <strong>Services</strong><br />
WP8954<br />
Counties Served:<br />
Charleston<br />
4 Carriage Lane, Suite 203-B<br />
Charleston SC 29407<br />
(843) 475-6447<br />
Wanda D. Tarpley<br />
<strong>Approved</strong><br />
Testing<br />
WP9953<br />
Counties Served:<br />
Statewide<br />
Post Office 407<br />
Irmo SC 29063<br />
(803) 331-0721<br />
Lynn McRae Taylor<br />
<strong>Approved</strong><br />
Counseling <strong>Services</strong><br />
WP9999<br />
Counties Served:<br />
Statewide<br />
486 Lisa Lane<br />
Mountain Rest SC 29664<br />
(864) 710-8108<br />
Lynn McRae Taylor<br />
<strong>Approved</strong><br />
Testing<br />
WP9999<br />
Counties Served:<br />
Statewide<br />
P.O. Box 6344<br />
Beau<strong>for</strong>t SC 29903<br />
(843) 305-9152<br />
Susan E. Thompson<br />
<strong>Approved</strong><br />
Counseling <strong>Services</strong><br />
WP8962<br />
Counties Served:<br />
Laurens<br />
Abbeville<br />
Greenwood<br />
McCormick<br />
117 Runnymeade Court<br />
Greenwood SC 29649<br />
(864) 227-6865<br />
S. Shonette Wilson<br />
<strong>Approved</strong><br />
Behavior Support<br />
WP8934<br />
Counties Served:<br />
Berkeley<br />
Calhoun<br />
Chestre<br />
Clarendon<br />
Darlington<br />
Dillon<br />
Fairfield<br />
Florence<br />
Georgetown<br />
Horry<br />
Kershaw<br />
Lee<br />
Marion<br />
Orangeburg<br />
Richland<br />
Sumter<br />
Williamsburg<br />
Systematic Behavioral Solutions,<br />
LLC<br />
108 Jimmie Lane<br />
Kingstree SC 29556<br />
(803) 413-2863<br />
Note: Some providers may be approved in several areas and serve different counties.
Name Provider Medicaid # Address/Phone #<br />
Status<br />
<strong>Approved</strong> Areas <strong>of</strong> Competence/Expertise<br />
Page 10<br />
Andrew Womack<br />
<strong>Approved</strong><br />
Behavior Support<br />
WP8935<br />
Counties Served:<br />
Statewide<br />
PO Box 802<br />
Beau<strong>for</strong>t SC 29901<br />
(843) 252-2947<br />
Wuying Zong<br />
<strong>Approved</strong><br />
Behavior Support<br />
Total: 59<br />
WP8941<br />
Counties Served:<br />
Statewide<br />
860 Harborside Lane<br />
Columbia SC 29229<br />
(803) 445-7896<br />
(803) 335-3921<br />
Note: Some providers may be approved in several areas and serve different counties.
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