Recently Updated NPI Information — some details in this NPI profile have been updated in the NPI registry within the last 60 days.

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

Q: 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.

Q: What is Woodrow Roeback's specialty?

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

Q: 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 34 days 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.

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: August 23, 2026.

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

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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

Phone(843) 501-1099

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

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Secondary Practice Location 1

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

Other Identifiers 1

Other15102754Caqh

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

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.

Other Providers at the Same Location NPPES

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

MRS. JANELL MARIA GARCED LPC

Counselor (Professional)

1103 48TH AVE N STE 201
MYRTLE BEACH, SC 29577

Horry County (843) 501-1099

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.

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 34 days 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.