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General NPI Number Information
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NPI Number | 1053847285
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Entity Type | Organization
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Legal Business Name | CHESTNUT HILL MENTAL HEALTH CENTER, INC
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Dates
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Enumeration Date | 05/09/2017
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Last Update Date | 05/09/2017
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Provider Practice Location Address
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Address Line | 1 HAVENWOOD LN
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City | TRAVELERS REST
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State | SC
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Zip | 29690-9447
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Country | US
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Telephone | 864-834-8013
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Fax |
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Provider Business Mailing Address
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Address Line | 1 HAVENWOOD LN
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City | TRAVELERS REST
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State | SC
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Zip | 29690-9447
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Country | US
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Telephone | 864-834-8013
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Fax |
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Authorized Official
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Title or Position | DIRECTOR OF BUSINESS DEVELOPMENT
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Name | DAVID B BURLESON
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Credential |
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Telephone | 864-834-8013
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 106E00000X
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Taxonomy Name | Assistant Behavior Analyst
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License Number |
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License Number State | SC
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Taxonomy #2
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Taxonomy Code | 106S00000X
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Taxonomy Name | Behavior Technician
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License Number |
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License Number State | SC
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Taxonomy #3
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Taxonomy Code | 133N00000X
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Taxonomy Name | Nutritionist
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License Number |
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License Number State | SC
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Taxonomy #4
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Taxonomy Code | 133V00000X
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Taxonomy Name | Registered Dietitian
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License Number |
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License Number State | SC
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Taxonomy #5
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number |
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License Number State | SC
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Taxonomy #6
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Taxonomy Code | 225X00000X
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Taxonomy Name | Occupational Therapist
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License Number |
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License Number State | SC
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Taxonomy #7
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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 | SC
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Taxonomy #8
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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 | SC
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