MICHAEL THACKERY
NPI 1659182004
Counselor - Mental Health in North Charleston, SC

Q: What is Michael Thackery's NPI number?

The NPI number for Michael Thackery is 1659182004. It was assigned to this individual provider in the NPPES registry on January 15, 2025.

Q: What is Michael Thackery's specialty?

The primary specialty registered for this NPI is Counselor, specializing in Mental Health, with taxonomy code 101YM0800X.

Q: When was this NPI record last updated?

The NPPES record for Michael Thackery was last updated on January 15, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 21 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.

Active since January 15, 2025PECOS Enrolled

1495 REMOUNT RD STE 3A, NORTH CHARLESTON, SC 29406(843) 882-6880 Get Directions Write a Review

NPPES record last updated: January 15, 2025. Verified against the NPPES registry weekly; last sync: October 25, 2026.

On this page

About Michael Thackery NPPES

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

MICHAEL THACKERY (NPI 1659182004) is an individual mental health provider in North Charleston, South Carolina, licensed in South Carolina (8875) and active in the NPI registry since January 2025. He is enrolled in Medicare PECOS and is a graduate of Other (2020).

NPPES Registry Identity

NPI1659182004

Entity TypeIndividualMale

Primary Taxonomy101YM0800X

Provider Legal NameMICHAEL THACKERY

Location Address1495 REMOUNT RD STE 3ANorth Charleston, SC 29406-3320

Mailing Address1495 Remount Rd Ste 3aNorth Charleston, SC 29406-3320 · (843) 882-6880

Phone(843) 882-6880

Sole ProprietorNo

Medical School CMSOtherGraduated 2020

Enumeration DateJanuary 15, 2025

NPPES CertifiedJanuary 15, 2025

✔ NPI 1659182004 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyCounselor · Mental HealthBehavioral Health & Social Service Providers

Taxonomy Code101YM0800X

License✔ Licensed in SC · 8875

1495 REMOUNT RD STE 3A, North Charleston, SC 29406

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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Absolute Total Care, Ambetter Health, Ambetter of North Carolina and more.Insurance ›

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Michael Thackery is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

PECOS PAC ID749762623

PECOS Enrollment IDI20260302001171

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 Michael Thackery reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Breathe Life Counseling

Same address

Mental Health

1495 REMOUNT RD STE 3A
North Charleston, SC 29406

Reassigned Medicare billing, South Carolina enrollment
8 clinicians in this Medicare group

NPI 1649927492 (843) 882-6880

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 9

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

BREATHE LIFE COUNSELING

Counselor (Mental Health)