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General NPI Number Information
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NPI Number | 1013372689
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Entity Type | Organization
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Legal Business Name | A CHILD'S BRIGHT START
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Dates
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Enumeration Date | 12/23/2015
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Last Update Date | 01/07/2016
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Provider Practice Location Address
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Address Line | 22 PLEASANT RIDGE AVE
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City | GREENVILLE
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State | SC
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Zip | 29605-2112
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Country | US
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Telephone | 214-601-6208
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Fax |
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Provider Business Mailing Address
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Address Line | 22 PLEASANT RIDGE AVE
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City | GREENVILLE
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State | SC
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Zip | 29605-2112
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Country | US
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Telephone | 214-601-6208
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | KEINOSHA KEATON
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Credential | MSW
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Telephone | 214-601-6208
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101Y00000X
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Taxonomy Name | Counselor
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 103K00000X
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Taxonomy Name | Behavior Analyst
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 103T00000X
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Taxonomy Name | Psychologist
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License Number |
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License Number State |
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Taxonomy #5
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Taxonomy Code | 103TC1900X
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Taxonomy Name | Counseling Psychologist
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License Number |
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License Number State |
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Taxonomy #6
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Taxonomy Code | 103TM1800X
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Taxonomy Name | Intellectual & Developmental Disabilities Psychologist
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License Number |
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License Number State |
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Taxonomy #7
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Taxonomy Code | 104100000X
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Taxonomy Name | Social Worker
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License Number |
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License Number State |
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Taxonomy #8
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Taxonomy Code | 171M00000X
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Taxonomy Name | Case Manager/Care Coordinator
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License Number |
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License Number State |
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Taxonomy #9
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Taxonomy Code | 172V00000X
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Taxonomy Name | Community Health Worker
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License Number |
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License Number State |
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Taxonomy #10
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Taxonomy Code | 235Z00000X
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Taxonomy Name | Speech-Language Pathologist
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License Number |
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License Number State |
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Taxonomy #11
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number |
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License Number State |
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