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NPI Code Detail

MEDICARE: ANZETTA NEKOL PYLES LPC

MEDICARE: ANZETTA NEKOL PYLES LPC
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) CounselorSC
2101YP2500XProfessional CounselorSC

General Provider Information

NPI Number : 1437422755
Entity Type Code : Individual
Provider Name (Legal Business Name) : ANZETTA NEKOL PYLES LPC
Provider Business Mailing Address
First Line : 439 CONGAREE RD
Second Line :
City : GREENVILLE
State : SC
Zip : 29607-2867
Country : US
Telephone Number : 864-326-4225
Fax Number : 864-326-4233
Provider Business Practice Location Address
First Line : 439 CONGAREE RD
Second Line :
City : GREENVILLE
State : SC
Zip : 29607-2867
Country : US
Telephone Number : 864-326-4225
Fax Number : 864-326-4233
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/16/2012
Last Update Date : 12/01/2020

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