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General NPI Number Information
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NPI Number | 1952120024
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Entity Type | Organization
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Legal Business Name | DREAM ACADEMY OF SC
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Dates
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Enumeration Date | 10/07/2024
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Last Update Date | 10/08/2024
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Provider Practice Location Address
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Address Line | 124 N MAIN ST
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City | SUMTER
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State | SC
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Zip | 29150-4948
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Country | US
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Telephone | 866-323-7326
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Fax |
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Provider Business Mailing Address
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Address Line | 124 N MAIN ST
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City | SUMTER
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State | SC
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Zip | 29150-4948
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Country | US
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Telephone | 866-323-7326
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Fax |
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Authorized Official
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Title or Position | FOUNDER
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Name | MS. PATRICE GAINES
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Credential |
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Telephone | 866-323-7326
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) 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 | 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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Taxonomy #3
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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 #4
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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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 | 133NN1002X
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Taxonomy Name | Nutrition Education Nutritionist
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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 | 175T00000X
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Taxonomy Name | Peer Specialist
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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 | 207RA0000X
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Taxonomy Name | Adolescent Medicine (Internal Medicine) Physician
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License Number |
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License Number State |
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Taxonomy #8
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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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Taxonomy #9
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Taxonomy Code | 261QM0855X
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Taxonomy Name | Adolescent and Children Mental Health Clinic/Center
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License Number |
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License Number State |
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Taxonomy #10
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Taxonomy Code | 101Y00000X
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Taxonomy Name | Counselor
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License Number |
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License Number State |
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