Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Self Medical Group

Organization Mental Health Counselor · NPI 1720475221

Self Medical Group is a Mental Health Counselor in Greenwood, South Carolina. Registered with an NPI since 2015.

In the registry since
2015
Specialties on file
4
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Practice location Address checks out

210 Wells Ave
Greenwood, SC 29646-3843
Phone: (864) 943-4279
Fax: (864) 223-2642
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Pediatrics Physician (primary) Taxonomy 208000000X
Mental Health Counselor Taxonomy 101YM0800X
Family Nurse Practitioner Taxonomy 363LF0000X
Pediatric Nurse Practitioner Taxonomy 363LP0200X

Record details

NPI number1720475221
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Matthew Logan — President And Ceo · (864) 725-4253
Other names Pediatric Associates Greenwood, A Division Of Self Medical Group; Pediatric Associates Greenwood, A Division Of Self Medical Group
NPI enumeratedApril 22, 2015
Last updated in NPPESDecember 14, 2021
Certification dateDecember 14, 2021
Mailing address210 Wells Ave, Greenwood, SC 29646-3843

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