Healthcare Provider Details

I. General information

NPI: 1306296041
Provider Name (Legal Business Name): EVALUATION SERVICES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/14/2016
Last Update Date: 10/05/2021
Certification Date: 10/05/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

236 DANDELION TRAIL
ANDERSON SC
29621
US

IV. Provider business mailing address

236 DANDELION TRAIL
ANDERSON SC
29621
US

V. Phone/Fax

Practice location:
  • Phone: 864-314-4447
  • Fax: 864-844-9433
Mailing address:
  • Phone: 864-314-4447
  • Fax: 864-844-9433

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number1-05-2383
License Number StateSC
# 2
Primary TaxonomyN
Taxonomy Code103TS0200X
TaxonomySchool Psychologist
License Number3086
License Number StateSC

VIII. Authorized Official

Name: MR. TERRY BONNER ORR
Title or Position: BCBA/OWNER
Credential: BCBA
Phone: 864-844-9433