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NPI Code Detail

MEDICARE: MRS. CATHERINE CUMMINGS DUBOSE EDS, LPC

MEDICARE: MRS. CATHERINE CUMMINGS DUBOSE EDS, LPC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1101YP2500XProfessional Counselor3503SC

General Provider Information

NPI Number : 1366687808
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. CATHERINE CUMMINGS DUBOSE EDS, LPC
Provider Business Mailing Address
First Line : 7 PETTIGRU ST
Second Line :
City : GREENVILLE
State : SC
Zip : 29601-3028
Country : US
Telephone Number : 864-235-7501
Fax Number : 864-235-7503
Provider Business Practice Location Address
First Line : 7 PETTIGRU ST
Second Line :
City : GREENVILLE
State : SC
Zip : 29601-3028
Country : US
Telephone Number : 864-235-7501
Fax Number : 864-235-7503
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/12/2008
Last Update Date : 08/19/2011

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