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SOUTHEASTERN SUCCESS CENTER, LLC
NPI 1659800167
Counselor - Professional in Camden, SC

Active since June 08, 2017
911 LYTTLETON ST, CAMDEN, SC 29020(803) 713-7979(803) 728-2200 Get Directions Write a Review

NPPES record last updated: October 6, 2023. Verified against the NPPES registry weekly; last sync: October 25, 2026.

Record update history: Oct 6, 2023, Sep 6, 2021, Jun 8, 2017 (3 updates tracked since 2017).

About Southeastern Success Center, Llc NPPES

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

SOUTHEASTERN SUCCESS CENTER, LLC (NPI 1659800167) is a healthcare organization registered as a professional in Camden, South Carolina and active in the NPI registry since June 2017. The organization maintains a secondary practice location in Columbia and lists Mary Myers Bridges, Owner, as its authorized official.

NPPES Registry Identity

NPI1659800167
Entity TypeOrganization
Primary Taxonomy101YP2500X
Legal Business NameSOUTHEASTERN SUCCESS CENTER, LLC
Location Address911 LYTTLETON STCamden, SC 29020-4412
Mailing AddressPo Box 2487Camden, SC 29020-8009 · (803) 729-5161
Phone(803) 713-7979
Fax(803) 728-2200
Organization SubpartNo
Authorized OfficialMary Myers BridgesOwner · (803) 713-7979
Enumeration DateJune 8, 2017
Last NPPES UpdateOctober 6, 20233 updates tracked since enumeration
NPPES CertifiedOctober 6, 2023
✔ NPI 1659800167 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 3

★ Primary SpecialtyCounselor · ProfessionalBehavioral Health & Social Service Providers
Taxonomy Code101YP2500X
Also ListedCounselor · Addiction (Substance Use Disorder)Taxonomy 101YA0400X
Also ListedCounselor · Mental HealthTaxonomy 101YM0800X
911 LYTTLETON ST, Camden, SC 29020
Open in Google Maps ↗

Secondary Practice Location 1

Location 13612 Landmark Dr Ste BColumbia, SC 29204-4039 · Phone (803) 779-3548 · Fax (803) 779-7055

Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include BlueCross BlueShield of South Carolina.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Southeastern Success Center, Llc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

2

Medicare enrollment records show 2 clinicians reassign Medicare billing to Southeastern Success Center, LLC, which bills Medicare for the services they deliver. Of these, 1 practice at this address. They are listed nearest first.

Clinicians, nearest first (2)

Mary Bridges, LPC
Mental Health Counselor
NPI 1760808570
911 LYTTLETON ST
Camden, SC 29020
(803) 713-7979
✔ PECOS✔ Accepts MedicareSame address
Shakiyah Demelien
Mental Health Counselor
NPI 1891472510
2638 TWO NOTCH RD STE 210
Columbia, SC 29204
(803) 936-1550
✔ PECOS28 mi

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

Patient Reviews User submitted

Reviews are submitted by site visitors and approved by a human moderator before publication.

Review by Dorothy ***** March 6, 2024

5/5
Molly makes you feel comfortable and not judged. Helpful suggestions and guidance.
Provider 5/5 Office Staff 5/5
Visited this provider? Share your experience.

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 Southeastern Success Center, LLC's NPI number?

The NPI number for Southeastern Success Center, LLC is 1659800167. It was assigned to this organization in the NPPES registry on June 8, 2017.

Where is Southeastern Success Center, LLC located?

Southeastern Success Center, LLC is located at 911 Lyttleton St, Camden, SC 29020. The listed phone number is (803) 713-7979.

What is Southeastern Success Center, LLC's specialty?

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

Is Southeastern Success Center, LLC enrolled in Medicare?

Yes. Southeastern Success Center, LLC is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Southeastern Success Center, LLC?

According to the CMS Revalidation Reassignment List (October 2026 release), 2 clinicians, all in Mental Health Counselor, reassign their Medicare billing to Southeastern Success Center, LLC. A 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 the clinician's services. Of these, 1 practice at this address. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

What insurance does Southeastern Success Center, LLC accept?

Health plans from BlueCross BlueShield of South Carolina list Southeastern Success Center, LLC 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 Southeastern Success Center, LLC was last updated on October 6, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 years 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.