| Connected Pro, Llc | |
|
118 Academy Street Fort Mill SC 29715 | |
| (803) 336-1089 | |
| Not Available |
| Full Name | Connected Pro, Llc |
|---|---|
| Speciality | Counselor - Professional |
| Location | 118 Academy Street, Fort Mill, South Carolina |
| Authorized Official Name and Position | Nametris Blount (OWNER) |
| Authorized Official Contact | 8033361089 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Connected Pro, Llc 3160 Hwy 21 Suite 103 #19 Fort Mill SC 29715 Ph: (803) 336-1089 | Connected Pro, Llc 118 Academy Street Fort Mill SC 29715 Ph: (803) 336-1089 |
| NPI Number | 1700278165 |
|---|---|
| Provider Enumeration Date | 02/23/2015 |
| Last Update Date | 06/29/2020 |
| Certification Date | 06/29/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1700278165 | NPI | - | NPPES |
| 5370 | Other | SC | LICENSED PROFESSIONAL COUNSELOR |
| 0701007567 | Other | VA | LICENSED PROFESSIONAL COUNSELOR |
| 6115105 | Medicaid | NC | |
| 8855 | Other | NC | LICENSED PROFESSIONAL COUNSELOR |
| 6401016479 | Other | MI | LICENSED PROFESSIONAL COUNSELOR |
| C.1801012 | Other | OH | LICENSED PROFESSIONAL COUNSELOR |
| LPC010060 | Other | GA | LICENSED PROFESSIONAL COUNSELOR |
| PC1370 | Medicaid | SC |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YP2500X | Counselor - Professional | 5370 (South Carolina) | Primary |
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