DR. WOODROW ANTHONY ROEBACK III CPC, CRC, LPC
NPI 1356681241
Counselor - Professional in Myrtle Beach, SC

Active since March 01, 2013PECOS Enrolled
1103 48TH AVE N STE 201, MYRTLE BEACH, SC 29577(843) 501-1099(843) 405-2040 Get Directions Write a Review

NPPES record last updated: July 23, 2026. Verified against the NPPES registry weekly; last sync: October 25, 2026.

Record update history: Jul 23, 2026, Feb 23, 2021 (2 updates tracked since 2021).

About Dr. Woodrow Anthony Roeback Iii Cpc, Crc, Lpc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

DR. WOODROW ANTHONY ROEBACK III CPC, CRC, LPC (NPI 1356681241) is an individual professional provider in Myrtle Beach, South Carolina, licensed in South Carolina (12362) and active in the NPI registry since March 2013. He is enrolled in Medicare PECOS and maintains a secondary practice location in Palmdale.

NPPES Registry Identity

NPI1356681241
Entity TypeIndividualMale
Primary Taxonomy101YP2500X
Provider Legal NameDR. WOODROW ANTHONY ROEBACK IIICredential: CPC, CRC, LPC
Location Address1103 48TH AVE N STE 201Myrtle Beach, SC 29577-5418
Mailing Address1103 48th Ave N Ste 201Myrtle Beach, SC 29577-5418 · (843) 501-1099 · Fax (843) 405-2040
Fax(843) 405-2040
Sole ProprietorYes
Enumeration DateMarch 1, 2013
Last NPPES UpdateJuly 23, 20262 updates tracked since enumeration
NPPES CertifiedJuly 23, 2026
✔ NPI 1356681241 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 3

★ Primary SpecialtyCounselor · ProfessionalBehavioral Health & Social Service Providers
Taxonomy Code101YP2500X
Licenses✔ Licensed in SC · 12362✔ Licensed in CA · 9352
Also ListedCounselor · Mental HealthTaxonomy 101YM0800X · License CP0182 (NV), 128746726004 (UT)
Also ListedExclusive Provider OrganizationTaxonomy 302F00000X · License NV20131237531 (NV)
1103 48TH AVE N STE 201, Myrtle Beach, SC 29577

Secondary Practice Location 1

Location 1241 W Quail DrPalmdale, CA 93551-2943 · Phone (702) 917-9309 · Fax (702) 255-7171

Other Identifiers 1

Other15102754Caqh

Accepted Insurance

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Dr. Woodrow Anthony Roeback Iii Cpc, Crc, Lpc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment– Home Health Agency– Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Medicare Billing Reassignment

Medicare enrollment records show Woodrow Roeback reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Mental Health
871 LOWCOUNTRY BLVD STE 200
Mount Pleasant, SC 29464
  • Reassigned Medicare billing, South Carolina enrollment
  • 285 clinicians in this Medicare group

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Other Providers at the Same Location NPPES

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

Counselor (Professional)
1103 48TH AVE N STE 201
MYRTLE BEACH, SC 29577

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Woodrow Roeback's NPI number?

The NPI number for Woodrow Roeback is 1356681241. It was assigned to this individual provider in the NPPES registry on March 1, 2013.

Where is Woodrow Roeback located?

Woodrow Roeback practices at 1103 48th Ave N Ste 201, Myrtle Beach, SC 29577. The listed phone number is (843) 501-1099.

What is Woodrow Roeback's specialty?

The primary specialty registered for this NPI is Counselor, specializing in Professional, with taxonomy code 101YP2500X.

Is Woodrow Roeback enrolled in Medicare?

Yes. Woodrow Roeback is registered in the Medicare PECOS enrollment system.

Which organization bills Medicare for Woodrow Roeback's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Woodrow Roeback reassigns Medicare benefits to Charleston Counseling Center PC (Mount Pleasant, SC). The reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Woodrow Roeback's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Woodrow Roeback accept?

Health plans from Select Health list Woodrow Roeback as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Woodrow Roeback was last updated on July 23, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.