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General NPI Number Information
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NPI Number | 1164849782
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Entity Type | Organization
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Legal Business Name | EMERALD COUNSELING CENTER
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Dates
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Enumeration Date | 03/20/2014
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Last Update Date | 03/24/2017
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Provider Practice Location Address
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Address Line | 2575 LIN DO CT STE C
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City | SUMTER
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State | SC
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Zip | 29150-1832
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Country | US
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Telephone | 803-381-6033
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Fax | 803-462-4848
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Provider Business Mailing Address
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Address Line | 6550 TIPPERARY LN
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City | WEDGEFIELD
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State | SC
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Zip | 29168-9370
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Country | US
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Telephone | 803-381-6033
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Fax | 803-462-4848
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Authorized Official
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Title or Position | OWNER
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Name | CHRISTY T SLOCUM
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Credential | LISW-CP
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Telephone | 803-381-6033
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 9631
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License Number State | SC
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