| Mended Therapy Group | |
|
108 Central Ave Ste 5 Goose Creek SC 29445-3079 | |
| (803) 450-6479 | |
| Not Available |
| Full Name | Mended Therapy Group |
|---|---|
| Speciality | Counselor - Mental Health |
| Location | 108 Central Ave Ste 5, Goose Creek, South Carolina |
| Authorized Official Name and Position | Mccrae Carroll (THERAPIST) |
| Authorized Official Contact | 8034506479 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Mended Therapy Group 108 Central Ave Ste 5 Goose Creek SC 29445-3079 Ph: () - | Mended Therapy Group 108 Central Ave Ste 5 Goose Creek SC 29445-3079 Ph: (803) 450-6479 |
| NPI Number | 1124807847 |
|---|---|
| Provider Enumeration Date | 09/22/2023 |
| Last Update Date | 09/22/2023 |
| Certification Date | 09/21/2023 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1124807847 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YM0800X | Counselor - Mental Health | (* (Not Available)) | Primary |
| 106H00000X | Marriage & Family Therapist | (* (Not Available)) | Secondary |
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