| Tjr Enterprises Inc | |
|
222 E Main St Fl 3 Rock Hill SC 29730-4542 | |
| (412) 656-9633 | |
| Not Available |
| Full Name | Tjr Enterprises Inc |
|---|---|
| Speciality | Social Worker |
| Location | 222 E Main St Fl 3, Rock Hill, South Carolina |
| Authorized Official Name and Position | Jill Anne Reagan (OWNER) |
| Authorized Official Contact | 4126569633 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Tjr Enterprises Inc 920 Haddonfield Dr Fort Mill SC 29708-7829 Ph: (412) 656-9633 | Tjr Enterprises Inc 222 E Main St Fl 3 Rock Hill SC 29730-4542 Ph: (412) 656-9633 |
| NPI Number | 1174217582 |
|---|---|
| Provider Enumeration Date | 06/07/2023 |
| Last Update Date | 06/07/2023 |
| Certification Date | 06/07/2023 |
| Medicare PECOS PAC ID | 3577926195 |
|---|---|
| Medicare Enrollment ID | O20230830002097 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1174217582 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
| Provider Name | Kayla Pengelski |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1487260501 PECOS PAC ID: 4183037195 Enrollment ID: I20210113000353 |
| Provider Name | Amy Elizabeth Winters |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1811180698 PECOS PAC ID: 6406204957 Enrollment ID: I20231220003625 |
| Provider Name | Michele Husted |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1821612995 PECOS PAC ID: 8426409848 Enrollment ID: I20240110003349 |
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