| Cannon Psychological Associates, Pc | |
|
1376 Tiger Blvd Ste 210 Clemson SC 29631-2654 | |
| (864) 654-7848 | |
| (864) 654-5777 |
| Full Name | Cannon Psychological Associates, Pc |
|---|---|
| Speciality | Psychologist - Clinical |
| Location | 1376 Tiger Blvd Ste 210, Clemson, South Carolina |
| Authorized Official Name and Position | Elizabeth Tracy Goode (OFFICE MANAGER) |
| Authorized Official Contact | 8646547848 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Cannon Psychological Associates, Pc 1376 Tiger Blvd Ste 210 Clemson SC 29631-2654 Ph: (864) 654-7848 | Cannon Psychological Associates, Pc 1376 Tiger Blvd Ste 210 Clemson SC 29631-2654 Ph: (864) 654-7848 |
| NPI Number | 1447334198 |
|---|---|
| Provider Enumeration Date | 10/25/2006 |
| Last Update Date | 09/06/2023 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1447334198 | NPI | - | NPPES |
| PS0078 | Medicaid | SC |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103TC0700X | Psychologist - Clinical | 349 (South Carolina) | Primary |
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