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NPI Code Detail

MEDICARE: CHESTER COUNTY COMMISION ON ALCOHOL AND DRUG ABUSE

MEDICARE: CHESTER COUNTY COMMISION ON ALCOHOL AND DRUG ABUSE
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1101YA0400XAddiction (Substance Use Disorder) Counselor
2101YM0800XMental Health Counselor
3101YP2500XProfessional Counselor
4261QR0405XSubstance Use Disorder Rehabilitation Clinic/Center

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1154329308
Entity Type Code : Organization
Provider Name (Legal Business Name) : CHESTER COUNTY COMMISION ON ALCOHOL AND DRUG ABUSE
Provider Business Mailing Address
First Line : 130 HUDSON ST
Second Line :
City : CHESTER
State : SC
Zip : 29706-1524
Country : US
Telephone Number : 803-377-8111
Fax Number : 803-581-5380
Provider Business Practice Location Address
First Line : 130 HUDSON ST
Second Line :
City : CHESTER
State : SC
Zip : 29706-1524
Country : US
Telephone Number : 803-377-8111
Fax Number : 803-581-5380
Authorized Official
Title or Position : EXECUTIVE DIRECTOR
Name : MARIA T BATES
Credential :
Telephone Number : 803-377-8111
Provider Enumeration Date : 07/12/2005
Last Update Date : 05/04/2016

Similar Medicare Providers

1013141043 — MRS. KESHIA DONUEL KEITH PHD, LPCS, LPC
Practice Location Address:
130 HUDSON ST
CHESTER, SC
29706-1524
Practice Phone: 803-377-8111
Practice Fax:
1730476706 — MRS. JENNIFER JONES CAMPBELL BSW, CACI
Practice Location Address:
130 HUDSON ST
CHESTER, SC
29706-1524
Practice Phone: 803-377-8111
Practice Fax: 803-581-5380
1821385717 — LISA JEAN MONTEITH LPC
Practice Location Address:
130 HUDSON ST
CHESTER, SC
29706-1524
Practice Phone: 803-377-8111
Practice Fax: 803-581-5380
1386931285 — MRS. MARIA TERESA BATES CACII, NCACII
Practice Location Address:
130 HUDSON ST
CHESTER, SC
29706-1524
Practice Phone: 803-377-8111
Practice Fax: 803-581-5380
1518254416 — MISS SHANNON DERVAY LPC, NCC, CACI
Practice Location Address:
130 HUDSON ST
CHESTER, SC
29706-1524
Practice Phone: 803-377-8111
Practice Fax: 803-581-5380
1396033122 — MRS. BONNIE LOU SHANNON LPC
Practice Location Address:
130 HUDSON ST
CHESTER, SC
29706-1524
Practice Phone: 803-377-8111
Practice Fax:

Directions to “CHESTER COUNTY COMMISION ON ALCOHOL AND DRUG ABUSE ” Practice Location

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These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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