MEDICARE: MR. THOMAS GREGG FOLSE MA, MAP

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
1	101YP2500X	Professional Counselor	3362	SC

General Provider Information

NPI Number	:	1720066574
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. THOMAS GREGG FOLSE MA, MAP

Provider Business Mailing Address
First Line	:	6059 MOSSEY GROVE LN
Second Line	:
City	:	AWENDAW
State	:	SC
Zip	:	29429-6132
Country	:	US
Telephone Number	:	843-928-3970
Fax Number	:	843-928-4076

Provider Business Practice Location Address
First Line	:	1156 BOWMAN RD
Second Line	:	SUITE 200
City	:	MT PLEASANT
State	:	SC
Zip	:	29464-3803
Country	:	US
Telephone Number	:	843-991-0440
Fax Number	:	843-928-4076

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/03/2006
Last Update Date	:	07/08/2007

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