| Create Play Heal | |
|
1527 Wade Hampton Blvd Greenville SC 29609-5047 | |
| (864) 501-3633 | |
| (864) 448-1766 |
| Full Name | Create Play Heal |
|---|---|
| Speciality | Social Worker |
| Location | 1527 Wade Hampton Blvd, Greenville, South Carolina |
| Authorized Official Name and Position | Cheryl Childers (OWNER) |
| Authorized Official Contact | 8645013633 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Create Play Heal 1527 Wade Hampton Blvd Greenville SC 29609-5047 Ph: (864) 501-3633 | Create Play Heal 1527 Wade Hampton Blvd Greenville SC 29609-5047 Ph: (864) 501-3633 |
| NPI Number | 1518627330 |
|---|---|
| Provider Enumeration Date | 12/20/2021 |
| Last Update Date | 08/02/2024 |
| Certification Date | 08/02/2024 |
| Medicare PECOS PAC ID | 6103205331 |
|---|---|
| Medicare Enrollment ID | O20220619000028 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1518627330 | NPI | - | NPPES |
| Provider Name | Cheryl Childers |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1508110925 PECOS PAC ID: 6103140421 Enrollment ID: I20150115000396 |
| Provider Name | Angelica Means |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1568857837 PECOS PAC ID: 6709261761 Enrollment ID: I20220913000546 |
| Provider Name | Jamie Ann Manko |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1538773536 PECOS PAC ID: 9234572678 Enrollment ID: I20240213001645 |
| Provider Name | Hannah Patteson |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1629633631 PECOS PAC ID: 2567804495 Enrollment ID: I20240523002695 |
| Provider Name | Wesley Earl Davis |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1124135199 PECOS PAC ID: 9537501333 Enrollment ID: I20240524001383 |
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