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General NPI Number Information
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NPI Number | 1336568765
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Entity Type | Organization
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Legal Business Name | GRAVITY COUNSELING GROUP
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Dates
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Enumeration Date | 04/14/2014
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Last Update Date | 12/09/2024
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Provider Practice Location Address
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Address Line | 104 MAXWELL AVE STE 219
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City | GREENWOOD
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State | SC
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Zip | 29646-2641
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Country | US
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Telephone | 864-724-9187
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Fax | 864-448-1559
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Provider Business Mailing Address
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Address Line | 945 SUNSET DR
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City | GREENWOOD
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State | SC
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Zip | 29646-1807
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Country | US
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Telephone | 864-724-9187
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Fax | 864-448-1559
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Authorized Official
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Title or Position | CEO
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Name | MR. KERVIN SEARLES
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Credential | LPC
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Telephone | 864-321-0108
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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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 #2
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number |
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License Number State |
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