Outside Of The Box Therapy | |
206 W Meadow St Gaffney SC 29341-2350 | |
(864) 597-9493 | |
(864) 206-4563 |
Full Name | Outside Of The Box Therapy |
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Speciality | Community/Behavioral Health |
Location | 206 W Meadow St, Gaffney, South Carolina |
Authorized Official Name and Position | Christie Rogers Larke (CLININCAL DIRECTOR) |
Authorized Official Contact | 8645979493 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Outside Of The Box Therapy Po Box 170581 Spartanburg SC 29301-0029 Ph: (864) 597-2054 | Outside Of The Box Therapy 206 W Meadow St Gaffney SC 29341-2350 Ph: (864) 597-9493 |
NPI Number | 1386190288 |
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Provider Enumeration Date | 08/30/2016 |
Last Update Date | 11/07/2024 |
Certification Date | 11/07/2024 |
Medicare PECOS PAC ID | 4183166424 |
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Medicare Enrollment ID | O20240603000936 |
Identifier | Type | State | Issuer |
---|---|---|---|
1386190288 | NPI | - | NPPES |
PC1250 | Medicaid | SC |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
101YP2500X | Counselor - Professional | (* (Not Available)) | Secondary |
251S00000X | Community/behavioral Health | 5222 (South Carolina) | Primary |
Provider Name | Christie Rogers-larke |
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Provider Type | Practitioner - Mental Health Counselor |
Provider Identifiers | NPI Number: 1477849933 PECOS PAC ID: 5092257337 Enrollment ID: I20240603001198 |
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