=====================================================
General NPI Number Information
=====================================================
NPI Number | 1972396083
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | ALLISON DANIELLE BUMPAS MMFT, LMFTA
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 05/22/2025
-----------------------------------------------------
Last Update Date | 05/22/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 414 PETTIGRU ST STE A
-----------------------------------------------------
City | GREENVILLE
-----------------------------------------------------
State | SC
-----------------------------------------------------
Zip | 29601-3164
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 864-581-2686
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 224 MCCAULEY RD
-----------------------------------------------------
City | TRAVELERS REST
-----------------------------------------------------
State | SC
-----------------------------------------------------
Zip | 29690-8008
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 334-652-1881
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 106H00000X
-----------------------------------------------------
Taxonomy Name | Marriage & Family Therapist
-----------------------------------------------------
License Number | 8863
-----------------------------------------------------
License Number State | SC
-----------------------------------------------------