| Nutritional & Psychological Wellness, Llc | |
|
107 E Park Ave Greenville SC 29601-1631 | |
| (864) 735-0842 | |
| Not Available |
| Full Name | Nutritional & Psychological Wellness, Llc |
|---|---|
| Speciality | Counselor - Mental Health |
| Location | 107 E Park Ave, Greenville, South Carolina |
| Authorized Official Name and Position | Audrey Suzanne Connell (OWNER, LICENSED PROFESSIONAL COUNSE) |
| Authorized Official Contact | 8647350842 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Nutritional & Psychological Wellness, Llc 69 Sikes Cir Mauldin SC 29662-2590 Ph: (716) 628-8250 | Nutritional & Psychological Wellness, Llc 107 E Park Ave Greenville SC 29601-1631 Ph: (864) 735-0842 |
| NPI Number | 1821766007 |
|---|---|
| Provider Enumeration Date | 09/01/2021 |
| Last Update Date | 09/01/2021 |
| Certification Date | 09/01/2021 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1821766007 | NPI | - | NPPES |
| 1376895821 | Medicaid | SC | |
| 1376895821 | Other | SC | CIGNA |
| 1376895821 | Other | SC | BLUE CROSS BLUE SHIELD |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YM0800X | Counselor - Mental Health | (* (Not Available)) | Primary |
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