Healthcare Provider Details

I. General information

NPI: 1154171254
Provider Name (Legal Business Name): GOLDEN THREAD THERAPY SERVICES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/25/2024
Last Update Date: 03/25/2024
Certification Date: 03/23/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1518 MATLOCK CT
BOILING SPRINGS SC
29316-4841
US

IV. Provider business mailing address

2607 WOODRUFF RD STE E PMB 3098
SIMPSONVILLE SC
29681
US

V. Phone/Fax

Practice location:
  • Phone: 512-256-0227
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name: CHRISTIAN CHAPMAN
Title or Position: OWNER
Credential: LCSW
Phone: 512-785-7940