| Island Transitions Counseling And Consulting, Llc. | |
|
3226 Maybank Hwy Unit A Johns Island SC 29455-4858 | |
| (618) 559-1124 | |
| Not Available |
| Full Name | Island Transitions Counseling And Consulting, Llc. |
|---|---|
| Speciality | Social Worker |
| Location | 3226 Maybank Hwy Unit A, Johns Island, South Carolina |
| Authorized Official Name and Position | Kathryn Elaine Roosevelt (OWNER/CLINICIAN) |
| Authorized Official Contact | 6185591124 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Island Transitions Counseling And Consulting, Llc. 3226 Maybank Hwy Unit A Johns Island SC 29455-4858 Ph: (618) 559-1124 | Island Transitions Counseling And Consulting, Llc. 3226 Maybank Hwy Unit A Johns Island SC 29455-4858 Ph: (618) 559-1124 |
| NPI Number | 1396317145 |
|---|---|
| Provider Enumeration Date | 07/12/2021 |
| Last Update Date | 07/12/2021 |
| Certification Date | 07/12/2021 |
| Medicare PECOS PAC ID | 0143666727 |
|---|---|
| Medicare Enrollment ID | O20240306002636 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1396317145 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YP2500X | Counselor - Professional | (* (Not Available)) | Secondary |
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
| Provider Name | Kathryn E Roosevelt |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1467894055 PECOS PAC ID: 1658503727 Enrollment ID: I20160222002376 |
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