| The Fifth Season Center For Loss Grief And Transition | |
|
111 Mills Ave Greenville SC 29605-4017 | |
| (864) 241-8222 | |
| (864) 241-8222 |
| Full Name | The Fifth Season Center For Loss Grief And Transition |
|---|---|
| Speciality | Social Worker - Clinical |
| Location | 111 Mills Ave, Greenville, South Carolina |
| Authorized Official Name and Position | Pattie S Broderick (EXECUTIVE DIRECTOR) |
| Authorized Official Contact | 8644045070 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| The Fifth Season Center For Loss Grief And Transition 111 Mills Ave Greenville SC 29605-4017 Ph: (864) 241-8222 | The Fifth Season Center For Loss Grief And Transition 111 Mills Ave Greenville SC 29605-4017 Ph: (864) 241-8222 |
| NPI Number | 1245527001 |
|---|---|
| Provider Enumeration Date | 06/30/2011 |
| Last Update Date | 09/06/2011 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1245527001 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YP2500X | Counselor - Professional | 5150 (South Carolina) | Secondary |
| 1041C0700X | Social Worker - Clinical | 1305 (South Carolina) | Primary |
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