| Stilwell Counseling Llc | |
|
27 S Main St Travelers Rest SC 29690-1866 | |
| (864) 610-0658 | |
| Not Available |
| Full Name | Stilwell Counseling Llc |
|---|---|
| Speciality | Counselor |
| Location | 27 S Main St, Travelers Rest, South Carolina |
| Authorized Official Name and Position | Rebecca J Jackson (OWNER/MANAGER) |
| Authorized Official Contact | 8646100658 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Stilwell Counseling Llc Po Box 504 Travelers Rest SC 29690-0504 Ph: (864) 610-0658 | Stilwell Counseling Llc 27 S Main St Travelers Rest SC 29690-1866 Ph: (864) 610-0658 |
| NPI Number | 1750160586 |
|---|---|
| Provider Enumeration Date | 09/21/2023 |
| Last Update Date | 09/21/2023 |
| Certification Date | 04/19/2022 |
| Medicare PECOS PAC ID | 2264871656 |
|---|---|
| Medicare Enrollment ID | O20240607001038 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1750160586 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YP2500X | Counselor - Professional | (* (Not Available)) | Primary |
| Provider Name | Rebecca Jo Jackson |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1902069214 PECOS PAC ID: 9537508924 Enrollment ID: I20240418000661 |
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