| Vivify Psychiatric Services, Llc | |
|
108 E Main St Westminster SC 29693-1715 | |
| (864) 301-1303 | |
| Not Available |
| Full Name | Vivify Psychiatric Services, Llc |
|---|---|
| Speciality | Clinic/Center |
| Location | 108 E Main St, Westminster, South Carolina |
| Authorized Official Name and Position | Katrina Raye Flagg (OWNER/PROVIDER) |
| Authorized Official Contact | 8643011303 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Vivify Psychiatric Services, Llc Po Box 321 Westminster SC 29693-0321 Ph: (864) 301-1303 | Vivify Psychiatric Services, Llc 108 E Main St Westminster SC 29693-1715 Ph: (864) 301-1303 |
| NPI Number | 1871377671 |
|---|---|
| Provider Enumeration Date | 08/22/2023 |
| Last Update Date | 08/22/2023 |
| Certification Date | 08/22/2023 |
| Medicare PECOS PAC ID | 6305299629 |
|---|---|
| Medicare Enrollment ID | O20240201004377 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1871377671 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | (* (Not Available)) | Primary |
| Provider Name | Katrina Raye Flagg |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1104600170 PECOS PAC ID: 7113370438 Enrollment ID: I20240201004411 |
Foothills Family Counseling Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 150a School House Rd, Westminster, SC 29693 Phone: 864-280-9317 | |
Cooperative Counseling Services Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 107 Mcfarlin Way, Westminster, SC 29693 Phone: 864-784-2266 |