| South Carolina Online Counseling And Group Therapy, Llc | |
|
61 Riverwalk Blvd Ste H Ridgeland SC 29936-3252 | |
| (843) 636-5017 | |
| (843) 206-0256 |
| Full Name | South Carolina Online Counseling And Group Therapy, Llc |
|---|---|
| Speciality | Counselor - Professional |
| Location | 61 Riverwalk Blvd Ste H, Ridgeland, South Carolina |
| Authorized Official Name and Position | Leigh Diotalevi (ADMINISTRATOR) |
| Authorized Official Contact | 8436365017 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| South Carolina Online Counseling And Group Therapy, Llc 61 Riverwalk Blvd Ste H Ridgeland SC 29936-3252 Ph: (843) 636-5017 | South Carolina Online Counseling And Group Therapy, Llc 61 Riverwalk Blvd Ste H Ridgeland SC 29936-3252 Ph: (843) 636-5017 |
| NPI Number | 1154928448 |
|---|---|
| Provider Enumeration Date | 10/08/2020 |
| Last Update Date | 10/08/2020 |
| Certification Date | 10/08/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1154928448 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YP2500X | Counselor - Professional | (* (Not Available)) | Primary |
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