Healthcare Provider Details
I. General information
NPI: 1003921420
Provider Name (Legal Business Name): GOOD SUCCESS CONSULTING GROUP, LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 08/19/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
454 S ANDERSON RD STE 2 BTC 598
ROCK HILL SC
29730-3392
US
IV. Provider business mailing address
454 S ANDERSON RD STE 311 BTC 598
ROCK HILL SC
29730-3392
US
V. Phone/Fax
- Phone: 803-242-0778
- Fax: 877-752-1347
- Phone: 803-242-0778
- Fax: 877-752-1347
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 101YA0400X |
| Taxonomy | Addiction (Substance Use Disorder) Counselor |
| License Number | OTP - 087 |
| License Number State | SC |
VIII. Authorized Official
Name: MR.
C
STEVEN
SWEENEY
Title or Position: PRESIDENT / EXECUTIVE DIRECTOR
Credential: M.ED.
Phone: 803-242-0778