| Breckenridge Counseling Services Llc | |
|
200 N Main St Ste 301e Greenville SC 29601-5104 | |
| (732) 245-8505 | |
| (000) 000-0000 |
| Full Name | Breckenridge Counseling Services Llc |
|---|---|
| Speciality | Social Worker - Clinical |
| Location | 200 N Main St Ste 301e, Greenville, South Carolina |
| Authorized Official Name and Position | Sherry L Van Fossan (OWNER/SOLE PRACTIONER) |
| Authorized Official Contact | 7322458505 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Breckenridge Counseling Services Llc 98 E Mcbee Ave Unit 314 Greenville SC 29601-4881 Ph: (732) 245-8505 | Breckenridge Counseling Services Llc 200 N Main St Ste 301e Greenville SC 29601-5104 Ph: (732) 245-8505 |
| NPI Number | 1376060624 |
|---|---|
| Provider Enumeration Date | 08/28/2017 |
| Last Update Date | 08/28/2017 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1376060624 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | 12010 (South Carolina) | Primary |
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