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General NPI Number Information
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NPI Number | 1184451411
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Entity Type | Organization
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Legal Business Name | INTREPID CCE LLC
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Dates
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Enumeration Date | 09/19/2024
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Last Update Date | 10/07/2025
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Provider Practice Location Address
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Address Line | 837 PENDLETON ST
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City | PICKENS
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State | SC
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Zip | 29671-2578
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Country | US
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Telephone | 864-707-1160
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Fax | 864-305-4624
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Provider Business Mailing Address
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Address Line | 840 N OLD PENDLETON RD
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City | LIBERTY
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State | SC
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Zip | 29657-9769
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Country | US
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Telephone | 864-707-1160
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Fax | 803-306-7899
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Authorized Official
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Title or Position | OWNER/ORGANIZOR
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Name | NORMA BEDELL
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Credential | LPC
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Telephone | 864-404-7824
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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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 #2
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Taxonomy Code | 103TC2200X
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Taxonomy Name | Clinical Child & Adolescent Psychologist
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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 | 390200000X
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Taxonomy Name | Student in an Organized Health Care Education/Training Program
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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 | 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 #5
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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 #6
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Taxonomy Code | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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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 | 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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