Healthcare Provider Details

I. General information

NPI: 1487510822
Provider Name (Legal Business Name): RUTH YEH
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/30/2025
Last Update Date: 12/30/2025
Certification Date: 12/30/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

102 HOPE TRACE WAY
IRMO SC
29063-9546
US

IV. Provider business mailing address

102 HOPE TRACE WAY
IRMO SC
29063-9546
US

V. Phone/Fax

Practice location:
  • Phone: 803-467-4889
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number7608
License Number StateSC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: