MEDICARE: TRUE INSIGHTS THERAPY, LLC

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
1	1041C0700X	Clinical Social Worker

General Provider Information

NPI Number	:	1457933665
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	TRUE INSIGHTS THERAPY, LLC

Provider Business Mailing Address
First Line	:	1122 LADY ST OFC 239
Second Line	:
City	:	COLUMBIA
State	:	SC
Zip	:	29201-3489
Country	:	US
Telephone Number	:	803-855-1068
Fax Number	:

Provider Business Practice Location Address
First Line	:	1122 LADY ST OFC 239
Second Line	:
City	:	COLUMBIA
State	:	SC
Zip	:	29201-3489
Country	:	US
Telephone Number	:	803-855-1068
Fax Number	:

Authorized Official
Title or Position	:	OWNER/CLINICAL THERAPIST
Name	:	AMBER NICKERSON
Credential	:	LISW-CP
Telephone Number	:	803-855-1068

Provider Enumeration Date	:	04/27/2021
Last Update Date	:	04/27/2021

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