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NPI 1043872187 · live from the CMS NPI Registry

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Community/Behavioral Health in Georgetown, SC. National Provider Identifier 1043872187, active.

NPI record

NPI1043872187 Type 2 · organization
StatusActive
Primary specialtyCommunity/Behavioral Health 251S00000X
Practice location500 S Kaminski St, Georgetown, SC 29440
Practice phone843-932-7217
Mailing addressPo Box 51, Georgetown, SC 29442
EnumeratedJune 28, 2019
Last updatedJune 28, 2019
Authorized officialEbony Hughes, Sole Mbr

Taxonomies and licenses

TaxonomyCodeLicense
Counselor101Y00000X—
Counselor, Pastoral101YP1600X—
Counselor, Professional101YP2500X—
Counselor, School101YS0200X—
Clinic/Center, Adolescent and Children Mental Health261QM0855X—
Clinic/Center, Student Health261QS1000X—
Community/Behavioral Health primary251S00000X—

Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.