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General NPI Number Information
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NPI Number | 1487997730
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Entity Type | Organization
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Legal Business Name | GIOVANNA BURGESS GEATHERS, LLC
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Dates
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Enumeration Date | 04/04/2013
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Last Update Date | 01/22/2015
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Provider Practice Location Address
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Address Line | 24 VARDRY ST SUITE 103
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City | GREENVILLE
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State | SC
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Zip | 29601-3540
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Country | US
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Telephone | 864-451-2258
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Fax | 888-817-0606
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Provider Business Mailing Address
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Address Line | 220 CLEAR LAKE DR
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City | SIMPSONVILLE
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State | SC
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Zip | 29680-6208
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Country | US
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Telephone | 864-275-4022
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Fax | 888-817-0606
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Authorized Official
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Title or Position | CEO
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Name | GIOVANNA BURGESS GEATHERS
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Credential | LPC
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Telephone | 864-275-4022
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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 | 5375
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License Number State | SC
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