| Upstate Integrative Family Therapy, Llc | |
|
4328 Wade Hampton Blvd Suite C Taylors SC 29687 | |
| (864) 735-7174 | |
| Not Available |
| Full Name | Upstate Integrative Family Therapy, Llc |
|---|---|
| Speciality | Clinic/center - Mental Health (including Community Mental Health Center) |
| Location | 4328 Wade Hampton Blvd, Taylors, South Carolina |
| Authorized Official Name and Position | Lorie Porter (OWNER) |
| Authorized Official Contact | 8647357174 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Upstate Integrative Family Therapy, Llc 4328 Wade Hampton Blvd Suite C Taylors SC 29687 Ph: (864) 735-7174 | Upstate Integrative Family Therapy, Llc 4328 Wade Hampton Blvd Suite C Taylors SC 29687 Ph: (864) 735-7174 |
| NPI Number | 1760153100 |
|---|---|
| Provider Enumeration Date | 09/24/2021 |
| Last Update Date | 09/24/2021 |
| Certification Date | 09/24/2021 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1760153100 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | (* (Not Available)) | Primary |
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