Healthcare Provider Details

I. General information

NPI: 1932708831
Provider Name (Legal Business Name): CAROLINA COUNSELING AND PSYCHIATRY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/21/2020
Last Update Date: 10/21/2020
Certification Date: 10/21/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

52 PARKWAY COMMONS WAY
GREER SC
29650-5213
US

IV. Provider business mailing address

52 PARKWAY COMMONS WAY
GREER SC
29650-5213
US

V. Phone/Fax

Practice location:
  • Phone: 864-887-6190
  • Fax: 864-416-4799
Mailing address:
  • Phone: 864-887-6190
  • Fax: 864-416-4799

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number
License Number State

VIII. Authorized Official

Name: JENNIFER ELLEN HILL
Title or Position: PROGRAM DIRECTOR
Credential:
Phone: 864-887-6190