| Acting Out Loud Therapy, Llc | |
|
1156 Bowman Rd Unit 207 Mt Pleasant SC 29464-3858 | |
| (818) 442-9055 | |
| Not Available |
| Full Name | Acting Out Loud Therapy, Llc |
|---|---|
| Speciality | Counselor - Professional |
| Location | 1156 Bowman Rd Unit 207, Mt Pleasant, South Carolina |
| Authorized Official Name and Position | Shanta Payne (OWNER/CLINICIAN) |
| Authorized Official Contact | 8184429055 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Acting Out Loud Therapy, Llc 1050 Johnnie Dodds Blvd Unit 1283 Mt Pleasant SC 29465-2862 Ph: (818) 442-9055 | Acting Out Loud Therapy, Llc 1156 Bowman Rd Unit 207 Mt Pleasant SC 29464-3858 Ph: (818) 442-9055 |
| NPI Number | 1730917675 |
|---|---|
| Provider Enumeration Date | 07/23/2024 |
| Last Update Date | 07/23/2024 |
| Certification Date | 07/23/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1730917675 | NPI | - | NPPES |
| PC2334 | Medicaid | SC |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YM0800X | Counselor - Mental Health | (* (Not Available)) | Secondary |
| 101YP2500X | Counselor - Professional | (* (Not Available)) | Primary |
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