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General NPI Number Information
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NPI Number | 1992511042
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Entity Type | Organization
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Legal Business Name | AGAPE TRANSFORMATION COUNSELING, LLC
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Dates
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Enumeration Date | 12/04/2024
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Last Update Date | 12/04/2024
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Provider Practice Location Address
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Address Line | 37 VILLA RD STE 206
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City | GREENVILLE
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State | SC
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Zip | 29615-3040
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Country | US
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Telephone | 864-729-3081
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Fax | 864-412-8689
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Provider Business Mailing Address
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Address Line | 228 REDWOOD DR
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City | EASLEY
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State | SC
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Zip | 29642-9027
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Country | US
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Telephone | 864-729-3081
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Fax |
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Authorized Official
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Title or Position | OWNER/CEO
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Name | CELISA ANN PATTERSON
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Credential | LPC
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Telephone | 864-729-3081
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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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