| Odom Lpc Llc | |
|
7 Pettigru St Greenville SC 29601-3028 | |
| (864) 235-7501 | |
| (864) 235-7503 |
| Full Name | Odom Lpc Llc |
|---|---|
| Speciality | Clinic/center - Mental Health (including Community Mental Health Center) |
| Location | 7 Pettigru St, Greenville, South Carolina |
| Authorized Official Name and Position | Emily N Odom (OWNER) |
| Authorized Official Contact | 8644832291 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Odom Lpc Llc 7 Pettigru St Greenville SC 29601-3028 Ph: (864) 235-7501 | Odom Lpc Llc 7 Pettigru St Greenville SC 29601-3028 Ph: (864) 235-7501 |
| NPI Number | 1073174926 |
|---|---|
| Provider Enumeration Date | 06/21/2019 |
| Last Update Date | 01/08/2020 |
| Certification Date | 01/08/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1073174926 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | (* (Not Available)) | Primary |
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