Healthcare Provider Details

I. General information

NPI: 1144145301
Provider Name (Legal Business Name): INDIA MONA SUBER
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/13/2026
Last Update Date: 08/13/2026
Certification Date: 08/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

119 HUNTER RIDGE DRIVE
BOILING SPRINGS SC
29316
US

IV. Provider business mailing address

119 HUNTER RIDGE DRIVE
BOILING SPRINGS SC
29316
US

V. Phone/Fax

Practice location:
  • Phone: 864-285-8622
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number19150
License Number StateSC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: