Healthcare Provider Details

I. General information

NPI: 1871171280
Provider Name (Legal Business Name): MAYO HUNT SEXTON
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/30/2021
Last Update Date: 03/30/2021
Certification Date: 03/30/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1627 E NORTH ST
GREENVILLE SC
29607-1361
US

IV. Provider business mailing address

10 BROUGHTON DR
GREENVILLE SC
29609-3813
US

V. Phone/Fax

Practice location:
  • Phone: 864-757-3022
  • Fax:
Mailing address:
  • Phone: 478-397-3733
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: