| Bright Side Counseling | |
|
2277 Sunset Blvd West Columbia SC 29169-4713 | |
| (888) 796-1117 | |
| (803) 996-5228 |
| Full Name | Bright Side Counseling |
|---|---|
| Speciality | Counselor |
| Location | 2277 Sunset Blvd, West Columbia, South Carolina |
| Authorized Official Name and Position | Ken Ray Taylor (CHIEF EXECUTIVE OFFICER) |
| Authorized Official Contact | 8887961117 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Bright Side Counseling 2277 Sunset Blvd West Columbia SC 29169-4713 Ph: (888) 796-1117 | Bright Side Counseling 2277 Sunset Blvd West Columbia SC 29169-4713 Ph: (888) 796-1117 |
| NPI Number | 1427595941 |
|---|---|
| Provider Enumeration Date | 01/22/2017 |
| Last Update Date | 01/18/2024 |
| Certification Date | 01/18/2024 |
| Medicare PECOS PAC ID | 7911331418 |
|---|---|
| Medicare Enrollment ID | O20191216001568 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1427595941 | NPI | - | NPPES |
| PC1596 | Medicaid | SC |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YP2500X | Counselor - Professional | (* (Not Available)) | Primary |
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Secondary |
| Provider Name | Michelle Stevens |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1518262187 PECOS PAC ID: 9032542709 Enrollment ID: I20191211000107 |
| Provider Name | Charles Zane Crumpler |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1528618675 PECOS PAC ID: 6204245053 Enrollment ID: I20210506001570 |
| Provider Name | Ben A Boatwright |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1942392451 PECOS PAC ID: 2668816521 Enrollment ID: I20240219002673 |
| Provider Name | Kenneth Ray Taylor |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1760811137 PECOS PAC ID: 6103186119 Enrollment ID: I20240322003163 |
| Provider Name | Dallas William Kuhn |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1366984262 PECOS PAC ID: 5193165058 Enrollment ID: I20240425004006 |
| Provider Name | Charles Thomas Goodson |
|---|---|
| Provider Type | Practitioner - Marriage And Family Therapist |
| Provider Identifiers | NPI Number: 1689252686 PECOS PAC ID: 3072055243 Enrollment ID: I20240604001970 |
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