Healthcare Provider Details

I. General information

NPI: 1992475941
Provider Name (Legal Business Name): STARTING POINT OF KENTUCKY, PSC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/20/2021
Last Update Date: 09/20/2021
Certification Date: 09/20/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

434 SCOTT ST
COVINGTON KY
41011-2342
US

IV. Provider business mailing address

200 E BROAD ST STE 300
GREENVILLE SC
29601-2891
US

V. Phone/Fax

Practice location:
  • Phone: 800-805-6989
  • Fax:
Mailing address:
  • Phone: 800-805-6989
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code2084A0401X
TaxonomyAddiction Medicine (Psychiatry & Neurology) Physician
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code261QM1300X
TaxonomyMulti-Specialty Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: DR. RUPERT JAMES MCCORMAC IX
Title or Position: PRESIDENT
Credential: MD
Phone: 864-527-3145