| Palmetto Counseling & Consulting Services, Llc | |
|
1721 Ebenezer Rd Suite #225 Rock Hill SC 29732-4103 | |
| (803) 329-9639 | |
| (803) 329-5830 |
| Full Name | Palmetto Counseling & Consulting Services, Llc |
|---|---|
| Speciality | Social Worker |
| Location | 1721 Ebenezer Rd, Rock Hill, South Carolina |
| Authorized Official Name and Position | Richard M Schlauch (PRESIDENT) |
| Authorized Official Contact | 8033299639 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Palmetto Counseling & Consulting Services, Llc 1721 Ebenezer Rd Suite ##225 Rock Hill SC 29732-4103 Ph: (803) 329-9639 | Palmetto Counseling & Consulting Services, Llc 1721 Ebenezer Rd Suite #225 Rock Hill SC 29732-4103 Ph: (803) 329-9639 |
| NPI Number | 1487805529 |
|---|---|
| Provider Enumeration Date | 10/07/2008 |
| Last Update Date | 03/03/2017 |
| Medicare PECOS PAC ID | 2365592797 |
|---|---|
| Medicare Enrollment ID | O20090605000435 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1487805529 | NPI | - | NPPES |
| 6106250 | Medicaid | NC | |
| 9227 | Other | SC | MEDICARE PTAN |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YM0800X | Counselor - Mental Health | C005197 (North Carolina) | Secondary |
| 1041C0700X | Social Worker - Clinical | 7244 (South Carolina) | Primary |
| Provider Name | Tina Celeste Outlaw |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1407911332 PECOS PAC ID: 8022052364 Enrollment ID: I20050617000030 |
| Provider Name | Richard M Schlauch |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1104983980 PECOS PAC ID: 5597852236 Enrollment ID: I20090605000427 |
| Provider Name | Lisa Jane Merriam |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1346320991 PECOS PAC ID: 4688832579 Enrollment ID: I20171127000453 |
| Provider Name | Tyrone T Matthews |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1043533045 PECOS PAC ID: 3870714660 Enrollment ID: I20180515000244 |
| Provider Name | Elizabeth Crenshaw |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1740521475 PECOS PAC ID: 6406100130 Enrollment ID: I20181116000628 |
| Provider Name | Rebecca L Merli |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1992399182 PECOS PAC ID: 9537569124 Enrollment ID: I20210618001846 |
| Provider Name | Alaina R Kemp |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1912653619 PECOS PAC ID: 8820452998 Enrollment ID: I20230908001312 |
| Provider Name | Kelly M Richman |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1023164985 PECOS PAC ID: 0941655963 Enrollment ID: I20231011003111 |
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