Healthcare Provider Details

I. General information

NPI: 1013375534
Provider Name (Legal Business Name): GOOD DEEDS CASE MANAGEMENT SERVICES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/29/2016
Last Update Date: 12/27/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1324 SECESSIONVILLE RD
CHARLESTON SC
29412-8231
US

IV. Provider business mailing address

1324 SECESSIONVILLE RD
CHARLESTON SC
29412-8231
US

V. Phone/Fax

Practice location:
  • Phone: 843-697-4587
  • Fax:
Mailing address:
  • Phone: 843-697-4587
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251B00000X
TaxonomyCase Management Agency
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code103TS0200X
TaxonomySchool Psychologist
License Number4674
License Number StateSC

VIII. Authorized Official

Name: MRS. TIRIEKA BROWN BROWN
Title or Position: OWNER/OPERATOR
Credential: M.S., S.S.P, MHP
Phone: 843-697-4587