| Kaleidoscope Counseling | |
|
2153 E Main St C14 #385 Duncan SC 29334-8724 | |
| (864) 590-1077 | |
| Not Available |
| Full Name | Kaleidoscope Counseling |
|---|---|
| Speciality | Community/Behavioral Health |
| Location | 2153 E Main St, Duncan, South Carolina |
| Authorized Official Name and Position | Melissa Leigh Shorey (OWNER/PROVIDER) |
| Authorized Official Contact | 8644852500 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Kaleidoscope Counseling 7280 Reidville Rd Suite B Woodruff SC 29388-9792 Ph: (864) 485-2500 | Kaleidoscope Counseling 2153 E Main St C14 #385 Duncan SC 29334-8724 Ph: (864) 590-1077 |
| NPI Number | 1922542950 |
|---|---|
| Provider Enumeration Date | 12/09/2016 |
| Last Update Date | 08/06/2020 |
| Certification Date | 08/06/2020 |
| Medicare PECOS PAC ID | 9931526688 |
|---|---|
| Medicare Enrollment ID | O20200826003890 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1922542950 | NPI | - | NPPES |
| SW1141 | Medicaid | SC |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 106H00000X | Marriage & Family Therapist | 4594 (South Carolina) | Secondary |
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
| Provider Name | Melissa Leigh Shorey |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1093068041 PECOS PAC ID: 0840617593 Enrollment ID: I20200826003941 |
| Provider Name | Susan C Woods |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1790161610 PECOS PAC ID: 0345660825 Enrollment ID: I20201022000845 |
| Provider Name | Sherry Annette Mcadams |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1538721618 PECOS PAC ID: 3870992803 Enrollment ID: I20210525001406 |
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