Healthcare Provider Details

I. General information

NPI: 1407622467
Provider Name (Legal Business Name): ROADS TO RESILIENCY, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/30/2023
Last Update Date: 11/30/2023
Certification Date: 11/30/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

84 GROCE RD
LYMAN SC
29365-1761
US

IV. Provider business mailing address

321 EMMIE LN
WELLFORD SC
29385-9219
US

V. Phone/Fax

Practice location:
  • Phone: 864-439-7760
  • Fax:
Mailing address:
  • Phone: 864-593-6616
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License Number
License Number State

VIII. Authorized Official

Name: BRITTANY GREEN GREGORY
Title or Position: THERAPIST, OWNER
Credential: LMFT
Phone: 864-593-6616