| Upstate Mental Wellness, Llc | |
|
419 Se Main St Ste 203a-2 Simpsonville SC 29681-2673 | |
| (678) 230-0476 | |
| (833) 905-4587 |
| Full Name | Upstate Mental Wellness, Llc |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 419 Se Main St Ste 203a-2, Simpsonville, South Carolina |
| Authorized Official Name and Position | Lorene R Heuvelman-hutchinson (OWNER) |
| Authorized Official Contact | 6782300476 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Upstate Mental Wellness, Llc 419 Se Main St Ste 203a-2 Simpsonville SC 29681-2673 Ph: (678) 230-0476 | Upstate Mental Wellness, Llc 419 Se Main St Ste 203a-2 Simpsonville SC 29681-2673 Ph: (678) 230-0476 |
| NPI Number | 1811629926 |
|---|---|
| Provider Enumeration Date | 06/28/2022 |
| Last Update Date | 06/28/2022 |
| Certification Date | 11/02/2021 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1811629926 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
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