| Synergy Counseling Services Llc | |
|
627 Old Trolley Rd Ste A Summerville SC 29485-5673 | |
| (800) 552-4357 | |
| (678) 388-9244 |
| Full Name | Synergy Counseling Services Llc |
|---|---|
| Speciality | Counselor |
| Location | 627 Old Trolley Rd Ste A, Summerville, South Carolina |
| Authorized Official Name and Position | James H Moody (CEO/OWNER) |
| Authorized Official Contact | 8005524357 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Synergy Counseling Services Llc 627 Old Trolley Rd Ste A Summerville SC 29485-5673 Ph: (800) 552-4357 | Synergy Counseling Services Llc 627 Old Trolley Rd Ste A Summerville SC 29485-5673 Ph: (800) 552-4357 |
| NPI Number | 1801838552 |
|---|---|
| Provider Enumeration Date | 06/10/2006 |
| Last Update Date | 08/13/2024 |
| Certification Date | 08/13/2024 |
| Medicare PECOS PAC ID | 9638083298 |
|---|---|
| Medicare Enrollment ID | O20031118000188 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1801838552 | NPI | - | NPPES |
| PG0023 | Medicaid | SC | |
| PG0325 | Medicaid | SC | |
| GP9716 | Medicaid | SC | |
| GP9793 | Medicaid | SC | |
| PG0704 | Medicaid | SC | |
| PG0648 | Medicaid | SC |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YP2500X | Counselor - Professional | (* (Not Available)) | Primary |
| Provider Name | Tasha M Frederick |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1215132733 PECOS PAC ID: 4082769831 Enrollment ID: I20090901000251 |
| Provider Name | Michele Blanch-barr |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1245319342 PECOS PAC ID: 9133512692 Enrollment ID: I20220204000002 |
| Provider Name | Frank David Ruse |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1134247232 PECOS PAC ID: 3173991437 Enrollment ID: I20221118000297 |
| Provider Name | Michelle Erin Rocca |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1497346423 PECOS PAC ID: 2860838315 Enrollment ID: I20240307000625 |
| Provider Name | Jessica Laurin Carder |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1164185559 PECOS PAC ID: 5294171492 Enrollment ID: I20240311001525 |
| Provider Name | James H. Moody |
|---|---|
| Provider Type | Practitioner - Other (non-physician) |
| Provider Identifiers | NPI Number: 1588965511 PECOS PAC ID: 9032434238 Enrollment ID: I20240322000927 |
| Provider Name | Brandon Armond Aaron |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1285363051 PECOS PAC ID: 6901246818 Enrollment ID: I20240425001907 |
| Provider Name | Linda A Wolf |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1912498650 PECOS PAC ID: 6204378433 Enrollment ID: I20240604000501 |
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